Hepatitis C Virus Infection Associated with Oral Potentially Malignant Disorder, Oral Cancer, and Liver Diseases: A Community-Based Cross-Sectional Study.

Background/

Objectives

While smoking, areca nut chewing, and alcohol are established risk factors, Hepatitis C virus (HCV) infection has emerged as a potential risk for oral neoplasia. This study explores any association of HCV infection with oral potentially malignant disorder (OPMD) and oral cancer, following adjustment for HCV-related liver disease in a large screening cohort.

Methods

Data from 37,720 participants in the Changhua Community-Based Integrated Screening Program (2005-2014) with smoking or areca nut use history were analyzed. OPMD and cirrhosis were identified at screening, while oral and liver cancers were diagnosed during follow-up. Information on demographics, lifestyle, and clinical factors, including chronic and active HCV infection, was collected. Multinomial logistic regression was used to assess associations between HCV status and disease outcomes.

Results

The prevalence of hepatitis C viremia was higher in the OPMD group (4.4%) and oral cancer group (3.3%) compared to the screen-negative group (2.7%), and highest in the cirrhosis/liver cancer group (23.3%). The odds ratios of OPMD and oral cancer were 1.59 (95% CI: 1.20-2.01) and 1.22 (95% CI: 0.67-2.23), respectively, in subjects with hepatitis C viremia compared to those without. After adjusting for confounding factors, individuals with hepatitis C viremia were at increased risk of OPMD by 50% (aOR = 1.50; 95% CI: 1.17-1.92) but not a statistically significant elevated risk for oral cancer (aOR = 1.09; 95% CI: 0.59-2.01), which was possibly attenuated due to HCV-related liver disease (aOR = 11.59; 95% CI: 8.33-16.13).

Conclusions

HCV infection may act as an early risk factor for OPMD, though its progression to oral cancer may occur alongside the risk of HCV-related liver diseases. Including HCV status in screening may aid early detection and secondary prevention of oral cancer in high-risk groups.