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Evidence-Based Dermatology: Review |

Hepatitis C Virus and Lichen Planus:  A Reciprocal Association Determined by a Meta-analysis

Liu Shengyuan, PhD; Yao Songpo, MD; Wei Wen, MD; Tian Wenjing, PhD; Zhang Haitao, MD; Wang Binyou, PhD
Arch Dermatol. 2009;145(9):1040-1047. doi:10.1001/archdermatol.2009.200.
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Objective  To explore the association between hepatitis C virus (HCV) and lichen planus (LP) by performing a meta-analysis of observational studies of the association.

Data Sources  Bibliographical searches were conducted in the MEDLINE, EMBASE, and China National Knowledge Infrastructure (CNKI) databases without any language limitations.

Study Selection  Studies were selected when the following criteria were met: the coexistence of a study group and a control group, the reliable and nonselective use of the reference standards for the diagnosis of LP and HCV, and the proportion of events (the prevalence of HCV in patients with LP or the prevalence of LP in patients with HCV).

Data Extraction  Three investigators independently assessed abstracts for relevant studies, and 2 investigators independently reviewed all eligible studies.

Data Synthesis  Sixty-three articles entailing 7 studies were included in the meta-analysis. For the primary outcome of prevalence of events, the meta-analysis showed that there existed an important association between HCV and LP. In the comparison of the prevalence of HCV exposure among patients with LP with that of control participants, the odds ratio (OR) was 5.4 (95% confidence interval [CI], 3.5-8.3); in the prevalence of LP among patients with HCV compared with the prevalence among control participants, the OR was 2.5 (95% CI, 2.0-3.1). The subgroup analyses with geographical stratification did not show a significant association in studies from South Asia (P = .21), Africa (P = .15), and North America (P = .09), and the subgroup analyses from stratification by LP type also did not show a significant association in the isolated cutaneous type (P = .17). When strict criteria were applied, the results of sensitivity analysis remained robust.

Conclusion  Hepatitis C virus infection is associated with a statistically significant risk for development of LP, suggesting that the presence of either HCV or certain types of LP may be used as a predictive marker of the other in certain geographical regions.

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Figure 1.

Flowchart of article selection. CNKI indicates the China National Knowledge Infrastructure databases.

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Figure 2.

Meta-analysis of hepatitis C virus prevalence. The study group and control group are compared. In the “Study Group” and “Control Group” columns the numerators indicate the numbers of cases, and the denominators indicate the participants included. CI indicates confidence interval; OR, odds ratio. A source labeled “A” or “B” refers to 1 of the 2 studies discussed in that article.

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Figure 3.

Meta-analysis of lichen planus prevalence. The study group and control group are compared. In the “Study Group” and “Control Group” columns the numerators indicate the numbers of cases, and the denominators indicate the subjects included. CI indicates confidence interval; OR, odds ratio. A source labeled “A” or “B” refers to 1 of the 2 studies discussed in that article.

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