Taha Emad A, Mekky Mohamed A, Morsy Hanan, Saleh Medhat A, Nafeh Hanan M, Ez-Aldin Azza M, Sayed Sohair K
Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt.
Department of Gastroenterology & Tropical Medicine, Assiut University, Assiut, Egypt.
Arab J Gastroenterol. 2014 Sep-Dec;15(3-4):98-102. doi: 10.1016/j.ajg.2014.08.001. Epub 2014 Aug 28.
Concomitant hepatitis C virus (HCV) infection and psoriasis vulgaris (PV) are not uncommon coexisting diseases, especially in areas with high viral hepatitis endemicity. To date, data about the interaction between both diseases are scarce. Therefore, we aimed to describe the possible interplay between the HCV viral load and psoriatic activity in concomitant Egyptian diseased patients.
Between December 2011 and August 2013, all psoriatic patients attending Assiut University Hospital outpatient clinics were tested for HCV serologic assay. Patients with positively coexisting diseases were further reevaluated for psoriasis area severity index (PASI) score assessment, liver function tests, HCV-RNA-polymerase chain reaction (PCR) assays, and sonographic examination of the liver. For comparative purposes, another matched group (n=26) with psoriasis only (HCV-negative group) was enrolled as a control.
During the period of the study, 20 patients with concomitant PV and HCV infection (HCV-positive group; 50% males, mean age of 44.15±10.66 years) were recruited. The mean PASI score was 44.75±10.38 and clinical signs of liver dysfunction were observed in 40% (n=8), 100% had abnormal liver function tests (n=20), and 75% had sonographic findings of cirrhosis (n=15). The PASI score was significantly higher in the HCV-positive psoriatic group compared to the HCV-negative control (p<0.001). Significant correlations were detected between the PASI score and the viral loads, and also with alanine aminotransferase (ALT).
When HCV was found concomitantly with PV, a high possibility of severe disease pattern will be expected that entails special precautions in the treatment process.
丙型肝炎病毒(HCV)感染与寻常型银屑病(PV)并存并不罕见,尤其是在病毒性肝炎高发地区。迄今为止,关于这两种疾病之间相互作用的数据很少。因此,我们旨在描述埃及合并患病患者中HCV病毒载量与银屑病活动之间可能的相互作用。
2011年12月至2013年8月期间,对所有在阿斯尤特大学医院门诊就诊的银屑病患者进行HCV血清学检测。对合并疾病呈阳性的患者进一步重新评估银屑病面积严重程度指数(PASI)评分、肝功能检查、HCV-RNA聚合酶链反应(PCR)检测以及肝脏超声检查。为作比较,另纳入一组仅患银屑病的匹配组(n = 26)作为对照(HCV阴性组)。
在研究期间,招募了20例合并PV和HCV感染的患者(HCV阳性组;50%为男性,平均年龄44.15±10.66岁)。平均PASI评分为44.75±10.38,40%(n = 8)观察到肝功能障碍的临床体征,100%肝功能检查异常(n = 20),75%有肝硬化的超声检查结果(n = 15)。与HCV阴性对照组相比,HCV阳性银屑病组的PASI评分显著更高(p<0.001)。在PASI评分与病毒载量之间以及与丙氨酸氨基转移酶(ALT)之间均检测到显著相关性。
当HCV与PV同时存在时,预计会有严重疾病模式的高可能性,这在治疗过程中需要特别注意。