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14(2):115-127 (2003)     Crit Rev Oral Biol Med
© 2003 International and American Associations for Dental Research

ORAL DISEASES POSSIBLY ASSOCIATED WITH HEPATITIS C VIRUS

M. Carrozzo*
S. Gandolfo

Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, C. so Dogliotti 14, University of Turin, I-10126 Torino, Italy;

*corresponding author, marco.carrozzo{at}unito.it


CONTROVERSY

The worldwide prevalence of hepatitis C virus (HCV) is estimated to be around 3%, representing approximately 170 million infected individuals. Morbidity associated with HCV infection is due not only to the sequelae of chronic liver disease but also to a variety of extrahepatic manifestations, including that involving the oral cavity. In the review that follows, Drs. Carrozzo and Gandolfo discuss the controversial role of HCV in the mechanisms underlying the pathogenesis of two oral conditions—Sjögren’s-like sialadenitis and oral lichen planus.

— Olav Alvares, Editor

 

Morbidity associated with hepatitis C virus (HCV) infection can involve a variety of extrahepatic conditions, including lichen planus (LP) and sialadenitis, predominantly or exclusively involving the oral region, conditions which have been largely neglected in reviews. The literature suggests that HCV-infected patients may frequently have Sjögren-like sialadenitis with mild clinical symptoms, whereas oral LP may be significantly associated with HCV infections in Southern Europe and Japan but not in Northern Europe. These geographical differences could be related to immunogenetic factors such as the HLA-DR6 allele, significantly expressed in Italian patients with OLP and HCV. Analysis of experimental data suggests that HCV could be involved in the pathogenesis of both these diseases. Moreover, parotid lymphoma may arise in patients with sialadenitis, mainly with type II cryoglobulinemia. Little attention has been paid to oral health needs in HCV-infected patients and the variable effect of interferon-alpha therapy on oral tissues. Further research is needed, because of the potentially great influence of oral diseases possibly linked to HCV on the quality of life of millions of patients.

Key words. Hepatitis C virus, lichen planus, oral lichen planus, sialadenitis, Sjögren’s syndrome







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