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口腔扁平苔藓患者丙型肝炎病毒感染风险高吗?一项病例对照研究。

Are oral lichen planus patients at high risk of hepatitis C? A case-control study.

机构信息

Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Stomatol Oral Maxillofac Surg. 2022 Jun;123(3):e37-e42. doi: 10.1016/j.jormas.2021.07.013. Epub 2021 Jul 28.

DOI:10.1016/j.jormas.2021.07.013
PMID:34332181
Abstract

OBJECTIVE

To assess the correlation between oral lichen planus (OLP) and viral hepatitis C (HCV).

METHODS

This retrospective case-control study included a sample of OLP patients in a 3-year interval. The predictor variable was the presence of OLP (yes/no). The outcome variable was the diagnosis of HCV. Other study variables were grouped into demographic, anatomic, and clinical. Descriptive, bi- and multivariate statistics were computed with a significant level at P ≤ 0.05.

RESULTS

The sample was composed of 237 OLP patients (38.8% females) with a mean age of 59.9 ± 17.8 years (range, 17-96), and 948 age- and gender-matched control individuals. The significant higher frequency of HCV was identified in OLP patients (frequency: 19.8% vs. 2.1%; adjusted matched odds ratio [mOR], 9.5; 95% confidence interval [95% CI], 5.98 to 15.91; P < 0.0001; Pearson's Phi coefficient [r], 0.307). In the adjusted model, OLP with HCV was associated with 1) oro-cutaneous manifestations (mOR, 17.58; 95% CI, 1.92 to 161.26; P = 0.0059; Bayesian posterior probability of positive test [W], 96%), 2) any intraoral forms other than reticular/plaque-liked forms (mOR, 0.09; 95% CI, 0.04 to 0.18; P < 0.0001; W, 52%), and 3) poor response to topical corticosteroids (mOR, 0.05; 95% CI, 0.02 to 0.16; P < 0.0001; W, 88%).

CONCLUSIONS

OLP, especially oro-cutaneous disease or steroid-refractory OLP, are associated with an increased frequency of HCV. Not only HCV screening in OLP patients, but oral examination in HCV patients, are both recommended as primary preventive measures.

摘要

目的

评估口腔扁平苔藓(OLP)与丙型病毒性肝炎(HCV)之间的相关性。

方法

本回顾性病例对照研究纳入了 3 年内的 OLP 患者样本。预测变量为 OLP 的存在(是/否)。结果变量为 HCV 的诊断。其他研究变量分为人口统计学、解剖学和临床变量。使用 P≤0.05 的显著性水平计算描述性、双变量和多变量统计数据。

结果

样本由 237 名 OLP 患者(女性占 38.8%)组成,平均年龄为 59.9±17.8 岁(范围 17-96 岁),并匹配了 948 名年龄和性别相匹配的对照个体。在 OLP 患者中发现 HCV 的频率明显更高(频率:19.8%比 2.1%;调整后的匹配优势比 [mOR],9.5;95%置信区间 [95%CI],5.98 至 15.91;P<0.0001;Pearson 卡方系数 [r],0.307)。在调整模型中,患有 HCV 的 OLP 与 1)口-皮肤表现(mOR,17.58;95%CI,1.92 至 161.26;P=0.0059;贝叶斯阳性测试后验概率 [W],96%),2)除网状/斑块样形式以外的任何口腔内形式(mOR,0.09;95%CI,0.04 至 0.18;P<0.0001;W,52%)和 3)对局部皮质类固醇反应不佳(mOR,0.05;95%CI,0.02 至 0.16;P<0.0001;W,88%)相关。

结论

OLP,尤其是口-皮肤疾病或皮质类固醇难治性 OLP,与 HCV 频率增加相关。不仅应建议对 OLP 患者进行 HCV 筛查,还应建议对 HCV 患者进行口腔检查,作为初级预防措施。

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