Sugiyama T, Shimizu M, Ohnishi H, Noguchi N, Iwata K, Kojima Y, Watanabe Y, Kawase K, Fukutomi Y, Yamauchi O, Yasuda S, Yamada M, Kobayashi S, Kojima M
Department of Gastroenterology, Gifu Prefectural Gifu Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2000 May;97(5):568-74.
Hepatitis C virus (HCV) infection induces a variety of extrahepatic manifestations such as oral lichen planus (OLP). To clarify the role of HCV in the development of OLP, we investigated the occurrence of OLP in patients with chronic hepatitis C treated with interferon (IFN). Of 275 patients with chronic hepatitis C, 6 developed OLP during the IFN treatment. However, OLP developed in none of 230 patients with chronic hepatitis C who did not undergo the IFN therapy. The IFN treatment in chronic hepatitis C patients developed OLP significantly, as compared with the non-treated group (p < 0.05). 4 of 6 patients who developed OLP during the IFN treatment had a complete response with normalization of ALT levels and undetectable HCV RNA after the treatment. There were no significant correlations between the effect of the IFN treatment and outcome of OLP. Furthermore, 3 of the 6 patients developed OLP, when serum HCV RNA became negative. These results suggest that direct viral factors may not be important in the pathogenesis of OLP in patients with chronic hepatitis C. Immunological changes caused by IFN may play a role in the development of OLP associated with HCV infection.
丙型肝炎病毒（HCV）感染可引发多种肝外表现，如口腔扁平苔藓（OLP）。为阐明HCV在OLP发病中的作用，我们调查了接受干扰素（IFN）治疗的慢性丙型肝炎患者中OLP的发生情况。在275例慢性丙型肝炎患者中，6例在IFN治疗期间出现了OLP。然而，在230例未接受IFN治疗的慢性丙型肝炎患者中，无1例出现OLP。与未治疗组相比，慢性丙型肝炎患者接受IFN治疗后发生OLP的情况显著增多（p < 0.05）。在IFN治疗期间出现OLP的6例患者中，有4例在治疗后ALT水平恢复正常且HCV RNA检测不到，达到了完全缓解。IFN治疗效果与OLP的转归之间无显著相关性。此外，6例患者中有3例在血清HCV RNA转为阴性时出现了OLP。这些结果表明，直接的病毒因素在慢性丙型肝炎患者OLP的发病机制中可能并不重要。IFN引起的免疫变化可能在与HCV感染相关的OLP发病中起作用。
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