BACKGROUND
Red lichen planus of the oral mucosa is a chronic inflammatory disease affecting the oral mucosa. Lichen planus of the oral cavity (CPL) and hyposalivation are among the extrahepatic manifestations associated with hepatitis C virus (HCV) infection. Patients with chronic hepatitis C often suffer from these oral diseases, which can significantly affect their quality of life. This is a common disease that affects about 1—2% of the world’s population.
OBJECTIVE
The aim of the study was to evaluate the effectiveness of direct antiviral agents in the treatment of CPL and hyposalivation in patients with chronic hepatitis C.
MATERIAL AND METHODS
A total of 215 patients were tested for HCV antibodies. The study included a comprehensive examination of patients before, during and after the use of antiviral drugs. Patients with a positive test result underwent quantitative HCV RNA testing and HCV genotype typing. In addition, the patients underwent oral examination using the CPL score system (REU scale) and the clinical Oral Dryness Scale (CODS). Subsequently, all eligible patients received antiviral therapy using glecaprevir /pibrentasvir (Maviret), and the condition of their oral cavity was systematically assessed 1, 3 and 6 months after the start of treatment.
RESULTS
Of the 215 patients who underwent the examination, 17 patients (7.9%) tested positive for HCV RNA. At the initial assessment, CPL was diagnosed in 4 patients (1.86%) with an average REU score of 10.13±4. In addition, 7 patients (3.26%) had hyposalivation of varying degrees with an average CODS score of 4.71±1.72. Six months after the start of therapy, there was a noticeable improvement in the condition of the oral cavity of patients. In particular, CPL was resolved in 3 out of 4 affected patients (75%), and the remaining patient had a significant decrease in the average REU score (2±4). Hyposalivation completely disappeared in 3 patients, improved in 2 patients and remained unchanged in 2 people. The average CODS score decreased significantly to 0.06±0.24 in patients with hyposalivation. The results highlight the potential benefits of antiviral drugs, in addition to their main role in eradicating HCV infection, and emphasize their value in eliminating concomitant extrahepatic manifestations, which ultimately improves the overall well-being of patients.
CONCLUSION
The results of this study emphasize the importance of regular screening of oral lesions in the examination of HCV-positive patients and have demonstrated a marked improvement in the indicators of CPL and hyposalivation among patients with HCV infection after therapy with direct-acting antiviral drugs.