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Ma SH, Tai YH, Dai YX, Chang YT, Chen TJ, Chen MH. Association between hepatitis C virus infection and subsequent chronic inflammatory skin disease. J Dermatol 2021; 48:1884-1891. [PMID: 34460962 DOI: 10.1111/1346-8138.16129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 12/27/2022]
Abstract
Hepatitis C virus (HCV) infection is associated with several cutaneous manifestations, including lichen planus and psoriasis. However, its association with other chronic inflammatory skin diseases (CISD) remains largely unknown. The aim of this study was to investigate the association between HCV infection and CISD. Participants were recruited from the National Health Insurance Research Database in Taiwan. Altogether 23 509 patients with HCV infection and 94 036 matched controls were included to assess the risk of CISD. A Cox regression model was used for the analyses. Compared with controls, patients with HCV infection had an adjusted hazard ratio (aHR) of 6.34 (95% confidence interval [CI], 5.30-7.58) for CISD after adjustment for potential confounders. Regarding individual CISD, patients with HCV infection had a significantly increased risk of developing lichen planus, psoriasis, vitiligo, alopecia areata, and cutaneous lupus erythematosus. Interferon-based antiviral therapy (IFN-based AVT) was significantly associated with a decreased risk of CISD (aHR = 0.42; 95% CI, 0.28-0.64). Patients with HCV infection had a significantly increased risk of CISD, while IFN-based AVT was associated with a decreased risk. These findings suggest monitoring of CISD in patients with HCV infection.
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Affiliation(s)
- Sheng-Hsiang Ma
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Hsuan Tai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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Rahman R, Hasija Y. Exploring vitiligo susceptibility and management: a brief review. BIOMEDICAL DERMATOLOGY 2018. [DOI: 10.1186/s41702-018-0030-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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3
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Czarny P, Merecz-Sadowska A, Majchrzak K, Jabłkowski M, Szemraj J, Śliwiński T, Karwowski B. The Influence of Hepatitis C Virus Therapy on the DNA Base Excision Repair System of Peripheral Blood Mononuclear Cells. DNA Cell Biol 2017; 36:535-540. [PMID: 28570836 DOI: 10.1089/dna.2017.3653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Hepatitis C virus (HCV) can infect extrahepatic tissues, including lymphocytes, creating reservoir of the virus. Moreover, HCV proteins can interact with DNA damage response proteins of infected cells. In this article we investigated the influence of the virus infection and a new ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin (OBV/PTV/r ± DSV ± RBV) anti-HCV therapy on the PBMCs (peripheral blood mononuclear cells, mainly lymphocytes) DNA base excision repair (BER) system. BER protein activity was analyzed in the nuclear and mitochondrial extracts (NE and ME) of PBMC isolated from patients before and after therapy, and from subjects without HCV, using modeled double-strand DNA, with 2'-deoxyuridine substitution as the DNA damage. The NE and ME obtained from patients before therapy demonstrated lower efficacy of 2'-deoxyuridine removal and DNA repair polymerization than those of the control group or patients after therapy. Moreover, the extracts from the patients after therapy had similar activity to those from the control group. However, the efficacy of apurinic/apyrimidinic site excision in NE did not differ between the studied groups. We postulate that infection of lymphocytes by the HCV can lead to a decrease in the activity of BER enzymes. However, the use of novel therapy results in the improvement of glycosylase activity as well as the regeneration of endonuclease and other crucial repair enzymes.
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Affiliation(s)
- Piotr Czarny
- 1 Department of Medical Biochemistry, Medical University of Lodz , Lodz, Poland
| | | | - Kinga Majchrzak
- 2 Department of Food Science, Medical University of Lodz , Lodz, Poland
| | - Maciej Jabłkowski
- 3 Department of Infectious and Liver Diseases, Medical University of Lodz , Lodz, Poland
| | - Janusz Szemraj
- 1 Department of Medical Biochemistry, Medical University of Lodz , Lodz, Poland .,4 Lodz Regional Science and Technology Park Ltd. , Lodz, Poland
| | - Tomasz Śliwiński
- 5 Laboratory of Medical Genetics, University of Lodz , Lodz, Poland
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4
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Karaca N, Ozturk G, Gerceker B, Turkmen M, Berdeli A. TLR2 and TLR4 gene polymorphisms in Turkish vitiligo patients. J Eur Acad Dermatol Venereol 2012; 27:e85-90. [DOI: 10.1111/j.1468-3083.2012.04514.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arya V, Bansal M, Girard L, Arya S, Valluri A. Vitiligo at Injection Site of PEG-IFN-α 2a in Two Patients with Chronic Hepatitis C: Case Report and Literature Review. Case Rep Dermatol 2010; 2:156-164. [PMID: 21076689 PMCID: PMC2978742 DOI: 10.1159/000320207] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A 72-year-old female and a 57-year-old male with chronic hepatitis C were treated with a combination therapy of pegylated interferon (PEG-IFN)-α 2a (180 μg s.c. once a week) and ribavirin (1,000 mg orally daily). This resulted in the destruction of melanocytes at the injection site in both patients. In the male patient, the depigmentation progressed to the surrounding skin area. The dermatologist concurred with vitiligo as the diagnosis in both patients. Injection and surrounding site vitiligo associated with PEG-IFN-α 2b treatment for hepatitis C was noticed in previous case studies. For the first time, the case reports below highlight the same immunological adverse event secondary to PEG IFN-α 2a/ribavirin combination therapy and explain, in part, the complex interaction between host immune response and viral genotype. In addition, we systematically review drug-induced vitiligo and autoimmune diseases associated with the depigmentation disorder.
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Affiliation(s)
- V Arya
- Wyckoff Heights Medical Center, Brooklyn, N.Y., USA
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6
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Abstract
Vitiligo is an acquired dyschromia of the skin in which there is a loss of epidermal melanocytes. The prevalence of vitiligo is approximately 1% in the United States and 0.1-2% worldwide. The exact pathogenesis of vitiligo remains elusive and is likely multifactorial. After completing this update, participants should be able to discuss the epidemiology of vitiligo and summarize the proposed mechanisms for development of this disease. In addition, they should be able to discuss physical findings, approach to the patient, and some of the therapeutic modalities for this disorder.
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Affiliation(s)
- Rebat M Halder
- Department of Dermatology, Howard University College of Medicine, Washington, DC 20060, USA.
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Taffaro M, Pyrsopoulos N, Cedron H, Cacayorin E, Weppler D, Moon J, Nishida S, Levi D, Kato T, Selvaggi G, Tzakis A, Schiff E. Vitiligo improvement in a hepatitis C patient after treatment with PEG-interferon alpha-2a and ribavirin: a case report. Dig Dis Sci 2007; 52:3435-7. [PMID: 17431776 DOI: 10.1007/s10620-006-9721-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Accepted: 12/03/2006] [Indexed: 12/09/2022]
Affiliation(s)
- M Taffaro
- University of Miami Center for Liver Disease and Division of Liver/GI Transplantation, Miami, Florida, USA
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Tomasiewicz K, Modrzewska R, Semczuk G. Vitiligo associated with pegylated interferon and ribavirin treatment of patients with chronic hepatitis C: a case report. Adv Ther 2006; 23:139-42. [PMID: 16644614 DOI: 10.1007/bf02850354] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The use of pegylated interferon (PEG-IFN) and ribavirin is considered standard therapy for patients with chronic hepatitis C. Many adverse effects of IFN appear to be of autoimmune origin. Vitiligo is a hypomelanotic disease, whose cause, despite many investigations, remains unknown, although some evidence points to an autoimmune pathogenesis. This report describes a case of vitiligo that occurred during the third month of treatment with PEG-IFN and ribavirin. The sustained virologic response was the result of a 52-week regimen; however, hypomelanotic cutaneous patches persisted. Autoimmune adverse effects of IFN therapy, which may include vitiligo, should be carefully monitored. The decision about whether to discontinue treatment should be discussed with the patient, who must be informed that the lesions may persist.
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