Lichen planus is associated with hepatitis C but not with hepatitis B virus: a systematic review and meta-analysis with a focus on Italian data

BACKGROUND: Several studies have explored the potential association between lichen planus (LP) and chronic hepatitis C (HCV) and hepatitis B virus (HBV) related, yielding conflicting results. Objective: To determine whether there is an association between these two entities, through a systemic review and meta-analysis. METHODS: Bibliographic searches were conducted using PubMed and Scopus databases. Data obtained from papers included in the systematic review were put into a quantitative meta-analysis, carried out with SPSS software version (29.0.2.0). RESULTS: Out of the initial pool of 834 studies, 45 studies met the inclusion criteria for meta-analysis. The odds ratio (OR) for HCV-seropositivity in LP patients was 4.55 (95% CI, 3.08-6.74), with higher ORs observed in Mediterranean basin countries (OR: 5.41, 95% CI: 3.16-9.29). In Italy, the OR was 4.42 (95% CI, 1.99-9.81). A regional variation was noted within Italy, with a higher OR in northern Italy-compared to southern Italy. Similar associations were found in Asian countries, with an OR of 4.49 (95% CI, 2.94-6.88). However, in northern Europe, the pooled OR was 0.733 (95% CI, 0.15-3.66), indicating no statistically significant association. When considering subjects with HCV infection, the presence of LP showed a pooled OR of 3.22 (95% CI, 1-10.34). Regarding HBV infection, the OR was 1.51 (95% CI, 1.15-1.97), with no differences and was similar when analyzing different subgroups. CONCLUSIONS: Our study indicates a moderate to high risk for HCV in patients with LP, according to geographic region, while the risk remains uncertain for HBV with respective ORs of 4.55 (95% CI, 3.08-6.74) and 1.51 (95% CI, 1.15-1.97). It seems reasonable to test the sera of patients affected by LP for anti-HCV antibodies, while the necessity of testing for HBV remains more uncertain.