Nagao Yumiko, Nakasone Kazunori, Maeshiro Tatsuji, Nishida Nao, Kimura Kanae, Kawahigashi Yuji, Tanaka Yasuhito, Sata Michio
Department of Organ System Interactions and Information, Faculty of Medicine, Saga University, Saga, Japan.
Nakasonekazu Medical Clinic, Naha, Japan.
Case Rep Gastroenterol. 2017 Nov 29;11(3):701-710. doi: 10.1159/000484132. eCollection 2017 Sep-Dec.
Hepatitis C virus (HCV) infection is frequently associated with various extrahepatic manifestations, such as autoimmune features and immune complex deposit diseases. Oral lichen planus (OLP) is one such extrahepatic manifestation of HCV infection. Recently, direct-acting antivirals (DAA) have proved to be highly effective and safe for the eradication of HCV. Herein, we report a case of OLP accompanied by HCV-related hepatocellular carcinoma (HCC) that disappeared after liver transplantation and achievement of sustained virological response following interferon (IFN)-free treatment with ledipasvir (LDV) and sofosbuvir (SOF). The 50-year-old patient developed erosive OLP during IFN therapy, with hyperthyroidism at 53 years of age and HCC at 55 years. He received immunosuppressive drugs and IFN-free DAA treatment after liver transplantation at 60 years of age, which led to disappearance of the symptoms of OLP. The patient was treated safely and effectively with LDV/SOF, although it is not known whether the disappearance of OLP resulted from the eradication of HCV or the immunosuppressive therapy.
丙型肝炎病毒（HCV）感染常与各种肝外表现相关，如自身免疫特征和免疫复合物沉积疾病。口腔扁平苔藓（OLP）就是HCV感染的一种肝外表现。最近，直接抗病毒药物（DAA）已被证明对根除HCV非常有效且安全。在此，我们报告一例伴有HCV相关肝细胞癌（HCC）的OLP病例，该病例在肝移植后消失，且在接受来迪派韦（LDV）和索磷布韦（SOF）的无干扰素治疗后实现了持续病毒学应答。这位50岁的患者在干扰素治疗期间出现糜烂性OLP，53岁时患甲状腺功能亢进，55岁时患HCC。他在60岁接受肝移植后接受了免疫抑制药物和无干扰素DAA治疗，这导致OLP症状消失。患者接受LDV/SOF治疗安全有效，尽管尚不清楚OLP的消失是由于HCV的根除还是免疫抑制治疗。
