Division of Clinical and Molecular Hepatology, University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
J Viral Hepat. 2020 Mar;27(3):333-337. doi: 10.1111/jvh.13230. Epub 2019 Nov 26.
Apart from chronic liver disease, hepatitis C virus (HCV) may be responsible for several extra-hepatic manifestations. Its involvement in psoriasis development is still controversial. The aim of this study was to evaluate the possible effect of anti-HCV direct-acting antiviral (DAA) treatment on cutaneous psoriasis. Thirty-seven consecutive HCV patients with cutaneous psoriasis underwent efficacious DAA treatment, and all of them were efficiently cured as shown by HCV RNA negativity 24 weeks after stopping therapy (PT24W). An expert dermatologist evaluated the skin lesions at baseline, end of treatment (EOT) and PT24W using the psoriasis area severity index (PASI) scoring system. The impact on quality of life was measured with the Dermatologic Quality of Life Index (DLQI). Six patients had a stable disease throughout the study period, whereas 31/37 patients (83.8%) showed a significant improvement of the skin lesions at EOT (P < .0001). However, 24 of these 31 patients (77.4%) had a dramatic worsening of the psoriatic lesions at PT24W compared with EOT (P < .001), with lesion severity comparable to baseline. The outcome of psoriasis during and after treatment was independent of baseline PASI score, age, sex, HCV genotype, liver disease stage and of the presence of arterial hypertension, diabetes and autoimmune diseases. In conclusion, DAA-based HCV cure has only a transient effect on skin lesions of patients with concomitant cutaneous psoriasis.
除了慢性肝病，丙型肝炎病毒（HCV）可能是导致多种肝外表现的原因之一。其在银屑病发病机制中的作用仍存在争议。本研究旨在评估抗 HCV 直接作用抗病毒（DAA）治疗对皮肤银屑病的可能影响。37 例连续的伴有皮肤银屑病的 HCV 患者接受了有效的 DAA 治疗，所有患者在停药 24 周后（PT24W）HCV RNA 阴性，均被有效治愈。一位专家皮肤科医生使用银屑病面积严重程度指数（PASI）评分系统在基线、治疗结束时（EOT）和 PT24W 评估皮肤病变。使用皮肤病生活质量指数（DLQI）评估对生活质量的影响。6 例患者在整个研究期间病情稳定，而 37 例患者中有 31 例（83.8%）在 EOT 时皮肤病变明显改善（P<.0001）。然而，这 31 例患者中有 24 例（77.4%）在 PT24W 时与 EOT 相比，银屑病病变急剧恶化（P<.001），病变严重程度与基线相当。治疗期间和治疗后的银屑病结局与基线 PASI 评分、年龄、性别、HCV 基因型、肝病分期以及是否存在动脉高血压、糖尿病和自身免疫性疾病无关。总之，基于 DAA 的 HCV 治愈对伴有皮肤银屑病的患者的皮肤病变仅有短暂影响。
