Yoshikawa Ayumu, Terashita Katsumi, Morikawa Kenichi, Matsuda Soichiro, Yamamura Takahiro, Sarashina Koichiro, Nakano Shintaro, Kobayashi Yoshimitsu, Sogabe Susumu, Takahashi Kazuhiro, Haba Shin, Oda Hisashi, Takahashi Tatsuro, Miyagishima Takuto, Sakamoto Naoya
Department of Internal Medicine, Kushiro Rosai Hospital, Kushiro, Japan.
Division of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan.
Clin J Gastroenterol. 2017 Jun;10(3):270-273. doi: 10.1007/s12328-017-0742-3. Epub 2017 Apr 26.
Hepatitis C virus (HCV) infection remains the main cause of liver disease and can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. HCV may also develop extrahepatic manifestations in the skin, eyes, joints, kidneys, nervous system, and immune system. In fact, several studies reported that up to 70% of HCV patients experienced extrahepatic manifestations. Lichen planus (LP), which is an immune system disorder that is triggered by viral infections, allergens, and stress, can affect the skin, mouth, nails, and scalp. The association of LP with HCV has been reported, but the effect of HCV treatment on LP remission is controversial. We encountered a 53-year-old man with HCV genotype 2a and LP that were successfully treated with sofosbuvir and ribavirin for 12 weeks. After treatment, he achieved sustained virological response against HCV and remission of erosive LP lesions on the lip. In the era of interferon (IFN)-based treatment for HCV, exacerbation of autoimmune diseases is a common adverse event. Therefore, use of an IFN-free regimen of direct-acting antivirals for HCV might prevent the extrahepatic manifestation of an immune disorder.
丙型肝炎病毒（HCV）感染仍然是肝脏疾病的主要病因，可导致慢性肝炎、肝硬化和肝细胞癌。HCV还可能在皮肤、眼睛、关节、肾脏、神经系统和免疫系统出现肝外表现。事实上，多项研究报告称，高达70%的HCV患者有肝外表现。扁平苔藓（LP）是一种由病毒感染、过敏原和压力引发的免疫系统疾病，可累及皮肤、口腔、指甲和头皮。LP与HCV的关联已有报道，但HCV治疗对LP缓解的影响存在争议。我们遇到一名53岁男性，患有2a型HCV和LP，接受索磷布韦和利巴韦林治疗12周后获得成功。治疗后，他实现了对HCV的持续病毒学应答，唇部糜烂性LP病变也得到缓解。在基于干扰素（IFN）治疗HCV的时代，自身免疫性疾病的加重是一种常见的不良事件。因此，使用无IFN的直接作用抗病毒药物方案治疗HCV可能预防免疫紊乱的肝外表现。
