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Scelza G, Amato A, Pagano AM, Matteis GD, Caruso R, Scelza A, Sisalli L, Biasi SD, Marigliano F, Gagliardi M, Martina S, Iandolo A. Effect of hepatitis C antiviral therapy on oral lichen planus and hyposalivation in inmates. Ann Gastroenterol 2022; 35:74-79. [PMID: 34987292 PMCID: PMC8713335 DOI: 10.20524/aog.2021.0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background Oral lichen planus (OLP) and hyposalivation have been reported as extrahepatic manifestations of hepatitis C virus (HCV) infection. Our study evaluated the effect of direct antiviral agents (DAAs) on OLP and hyposalivation in convicts with chronic hepatitis C, examining patients before, during and after the antiviral treatment period with direct acting antiviral agents (DAAs). Methods We screened 198 inmates for the presence of the HCV antibody. Patients found to be positive underwent a quantitative HCV-RNA test and HCV genotype typing, as well as an oral cavity examination using a scoring system for OLP (REU score) and the clinical oral dryness score (CODS). Subsequently, all patients underwent DAA therapy and a systematic physical examination of the oral cavity at 1, 3 and 6 months from the beginning of treatment. Results Fifty patients (25.25%) had a positive HCV-RNA test. At baseline, OLP was detected in 4 patients (8%), with a mean REU score of 10.13±4, and different degrees of hyposalivation were seen in 17 patients (34%), with a mean CODS score of 4.71±1.72. Six months after the start of DAA therapy, we observed resolution of OLP in 3 patients (75%) and improvement in the remaining subject with a significantly lower mean REU score (2±4). Hyposalivation disappeared in 5 patients, improved in 10, and remained unchanged in 2 patients with a significantly lower mean CODS score (0.06±0.24). Conclusion This study demonstrated the effectiveness of DAAs in the treatment of OLP and hyposalivation.
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Affiliation(s)
- Giuseppe Scelza
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Alessandra Amato
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Antonio Maria Pagano
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Giuseppe De Matteis
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Rosa Caruso
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Antonio Scelza
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Laura Sisalli
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Sebastiana De Biasi
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Francesca Marigliano
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Mario Gagliardi
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno (Mario Gagliardi), Salerno, Italy
| | - Stefano Martina
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
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Khonsari RH, Maylin S, Nicol P, Martinot-Peignoux M, Créange A, Duyckaerts C, Bertolus C. Sicca syndrome and dementia in a patient with hepatitis C infection: a case report with unusual bifocal extrahepatic manifestations. J Maxillofac Oral Surg 2015; 14:388-92. [PMID: 25848147 DOI: 10.1007/s12663-014-0632-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 05/20/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Hepatitis C virus (HCV) infections are associated with extrahepatic manifestations in 40-75 % of cases. Sialitis and secondary Sjögren syndrome are well characterized complications of chronic HCV infections but the mechanisms (primary or secondary) leading to xerostomia are not understood. Similarly, brain lesions due to HCV can be primary or secondary but the pathology of primary HCV-related brain lesions is not well described. CASE REPORT We report the postmortem case of a 60-year old patient initially presenting with sicca syndrome and dementia. HCV was identified in the brain but not in the salivary glands using transcription-mediated amplification (TMA). Focal sialitis was found in submandibular glands. Neuropathological examination revealed the presence of multiple dot-sized demyelination foci. CONCLUSION Sicca syndrome is a common concern in chronic HCV infections and may be due to secondary immune mechanisms (we could not isolate HCV in salivary gland tissues). TMA had never been applied to the detection of viruses in salivary glands and neural tissues and proves to be a promising technique. Neuropathological reports in HCV infections are rare and the lesions we report may be the first characterization of the direct effect of HCV on brain cells. More cases are needed to define the full spectrum of lesions potentially caused by the direct action of the HCV on salivary glands and neural tissues.
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Affiliation(s)
- R H Khonsari
- Service de Chirurgie Maxillofaciale et Stomatologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France ; UPMC Université Paris 06, 75005 Paris, France ; Laboratoire de Neuropathologie Raymond-Escourolle, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - S Maylin
- Service de Microbiologie, Hôpital Beaujon, Clichy, France
| | - P Nicol
- Service de Chirurgie Maxillofaciale et Stomatologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France ; UPMC Université Paris 06, 75005 Paris, France
| | - M Martinot-Peignoux
- INSERM U-773, Centre de recherche biomédicale Bichat-Beaujon CRB3, Université Paris VII, Clichy, France
| | - A Créange
- Service de Neurologie, Hôpital Henri Mondor, Créteil, France
| | - C Duyckaerts
- UPMC Université Paris 06, 75005 Paris, France ; Laboratoire de Neuropathologie Raymond-Escourolle, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - C Bertolus
- Service de Chirurgie Maxillofaciale et Stomatologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France ; UPMC Université Paris 06, 75005 Paris, France
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Mortazavi H, Baharvand M, Movahhedian A, Mohammadi M, Khodadoustan A. Xerostomia due to systemic disease: a review of 20 conditions and mechanisms. Ann Med Health Sci Res 2014; 4:503-10. [PMID: 25221694 PMCID: PMC4160670 DOI: 10.4103/2141-9248.139284] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Xerostomia is a common complaint of nearly half of the elderly population and about one-fifth of younger adults. It causes several signs and symptoms, and compromise oral functions and health-related quality-of-life. Multiple reasons are proposed to describe the etiology of xerostomia such as local factors, psychogenic factors, and systemic diseases. In order to manage xerostomia effectively, identification of the main causality is mandatory. The aim of this review was to present systemic diseases leading to xerostomia with their mechanisms of action. We used various general search engines and specialized databases such as Google, Google Scholar, Yahoo, PubMed, PubMed Central, MedLine Plus, Medknow, EBSCO, ScienceDirect, Scopus, WebMD, EMBASE, and authorized textbooks to find relevant topics by means of Medical Subject Headings keywords such as "xerostomia," "hyposalivations," "mouth dryness," "disease," and "systemic." We appraised 97 English-language articles published over the last 40 years in both medical and dental journals including reviews, meta-analysis, original papers, and case reports. Upon compilation of relevant data, it was concluded that autoimmune diseases most frequently involve salivary glands and cause xerostomia followed by diabetes mellitus, renal failure, and graft-versus-host disease. Moreover, the underlying mechanisms of systemic disease-related xerostomia are: autoimmunity, infiltration of immunocompetent cells, granuloma formation, fibrosis and dehydration, deposition of proteinaceous substances, bacterial infection, and side-effects of medications.
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Affiliation(s)
- H Mortazavi
- Department of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Baharvand
- Department of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Movahhedian
- Dental Student, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Mohammadi
- Dental Student, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alavian SM, Mahboobi N, Mahboobi N, Karayiannis P. Oral conditions associated with hepatitis C virus infection. Saudi J Gastroenterol 2013; 19:245-51. [PMID: 24195977 PMCID: PMC3958971 DOI: 10.4103/1319-3767.121032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infection in more than 170 million chronically infected patients with no developed preventive vaccine is a globally important issue. In addition to expected hepatic manifestations, a number of extrahepatic manifestations, such as mixed cryoglobulinemia, glomerulonephritis, polyarteritis nodosa, rashes, renal disease, neuropathy, and lymphoma, have been reported following HCV infection, which are believed to be influenced by the virus or the host immune response. HCV combination therapy with pegylated interferon and ribavirin might be associated with side effects as well. The association of HCV with special oral conditions has also been reported recurrently; the mechanism of most of which remains unclear. This article reviews the association of HCV infection with some of the oral conditions such as oral health, Sjogren's syndrome, lichen planus and oral cancer.
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Affiliation(s)
- Seyed-Moayed Alavian
- Department of Gastroenterology and Hepatology, Baqiyatallah University of Medical Sciences, Research Center for Gastroenterology and Liver Disease, Tehran, Iran,Address for correspondence: Prof. Seyed-Moayed Alavian, Professor of Gastroenterology and Hepatology, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Ground Floor of Baqiyatallah Hospital, Mollasadra Avenue, Vanak Square, Tehran, Iran. E-mail:
| | - Nastaran Mahboobi
- Department of Neurology, Marien Hospital Euskirchen, Lehrkrankenhaus der Uni-Bonn, Germany
| | - Nima Mahboobi
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Peter Karayiannis
- Department of Medicine, Imperial College, Variety Wing Floor D, St Mary's Campus, Norfolk Place, London, England
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Caldeira PC, Oliveira e Silva KR, Silva TA, de Mattos Camargo Grossmann S, Teixeira R, Carmo MAVD. Correlation between salivary anti-HCV antibodies and HCV RNA in saliva and salivary glands of patients with chronic hepatitis C. J Oral Pathol Med 2012; 42:222-8. [DOI: 10.1111/j.1600-0714.2012.01201.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2012] [Indexed: 12/13/2022]
Affiliation(s)
- Patrícia Carlos Caldeira
- Department of Oral Pathology and Surgery; School of Dentistry, Universidade Federal de Minas Gerais; Belo Horizonte; Brazil
| | - Karla Rachel Oliveira e Silva
- Department of Oral Pathology and Surgery; School of Dentistry, Universidade Federal de Minas Gerais; Belo Horizonte; Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Pathology and Surgery; School of Dentistry, Universidade Federal de Minas Gerais; Belo Horizonte; Brazil
| | | | - Rosângela Teixeira
- Department of Medical Clinic; School of Medicine, Universidade Federal de Minas Gerais; Belo Horizonte; Brazil
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Abstract
Background The aim of this study was to assess risk factors for HCV acquisition and prevalence of anti-HCV in the general population of Lithuania. Material/Methods The study enrolled 1528 randomly selected adults from the 5 biggest cities of Lithuania and its rural regions. Screening for anti-HCV was performed by analysis of peripheral capillary blood with lateral flow immunochromatography and confirmation of positive cases by peripheral venous blood testing with 2-step chemiluminescent microparticle immunoassay. Results Anti-HCV prevalence in Lithuania is 2.78% and according to the standard European population the adjusted anti-HCV rate is 2.85%. It is more prevalent among men (crude rates: 4.02% males vs. 1.49% females, p=.0030) and this does not depend on age. Vilnius and Kaunas regions have higher infection rates than smaller rural regions (2.92% and 3.01% vs. 2.24%, 0.74% and 1.35%). Nowadays among our population HCV infection spreads mainly via intravenous drug use (OR=42.5, p<.0001). HCV transmission occurs through blood transfusions (OR=6.4, p=.0002), tooth removal (OR=4.1, p=.0048), childbirth (OR=5.0, p=.0224), multiple and a long-term hospitalization (OR=3.0, p=.0064), tattooing (OR=4.4, p=.0013), open traumas (OR=3.7, p=.0009) and intrafamilially (OR=11.3, p=.0002). Conclusions 2.78% of the population is anti-HCV-positive. The anti-HCV rate is higher in Vilnius and Kaunas in comparison with other regions. HCV spreads mainly through intravenous drug use, but intrafamilial and some nosocomial routes are also important. The anti-HCV prevalence did not depend on age. Despite active prevention of nosocomial HCV transmission, the incidence of HCV infection does not decrease due to virus spread mostly in “trusted networks” of intravenous drug users.
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Affiliation(s)
- Valentina Liakina
- Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Lithuania.
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Mahboobi N, Porter SR, Karayiannis P, Alavian SM. Oral fluid and hepatitis A, B and C: a literature review. J Oral Pathol Med 2011; 41:505-16. [PMID: 22188507 DOI: 10.1111/j.1600-0714.2011.01123.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Viral hepatitis is a significant global health problem that, depending upon the virus, affects individuals of the developing and/or developed world. In recent years, there has been renewed interest in whether oral fluids can be considered as a source of viral hepatitis transmission and whether oral fluid, in particular, whole saliva, may be a useful source for viral detection as part of the diagnosis and monitoring of viral hepatitis. The aim of this article was to review current data concerning the possible carriage of the hepatitis A, B and C viruses within saliva and gingival crevicular fluid. Such knowledge will indicate if (i) oral fluid is a possible source of infection and (ii) whether oral fluid can be used for diagnosis and monitoring of viral hepatitis. DATA AND SOURCES A literature search was conducted using PubMed (Medline), EMBASE/Excerpta medica, the Cochrane database and Scopus. The results were limited to published material after 2000. Relevant material was evaluated and reviewed. CONCLUSION There is some evidence that hepatitis viruses A, B and C are present in oral fluids, particularly whole saliva and gingival crevicular fluid and may thus be possible sources of viral detection in clinical diagnosis and monitoring. However, the data are inconsistent and warrant the need for well-planned longitudinal studies to explore the precise frequency of oral carriage of such viruses and to determine the virological and host factors that may influence the oral presence of hepatitis A, B and C viruses.
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Affiliation(s)
- Nima Mahboobi
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
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