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STUDIES
Year : 2005  |  Volume : 50  |  Issue : 4  |  Page : 200-202
Prevalence of hepatotrophic viruses b&c in psoriasis -A study from kashmir


Department of Dermatology, STD and Leprosy Government Medical College and Associated SMHS Hospital, Srinagar, Kashmir J & K, India

Correspondence Address:
Qazi Masood Ahmad
House No. 214, Karan Nagar, Srinagar, Kashmir, (J&K)
India
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Source of Support: None, Conflict of Interest: None


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   Abstract 

The association of psoriasis with hepatotrophic viruses B and C (HBV& HCV ) infection has been reported with conflicting results in literature .This association has never been investigated in Kashmir where the prevalence of psoriasis in the general population varies from 2.4 to 3.4 % and the epidemiology of chronic liver disease reveals infection with HBV and HCV to be causative in 25% and 45% of the cases respectively. The aim of this study was to determine the prevalence of HbsAg and anti- HCV antibody amongst Kashmiri patients with psoriasis. Fifty Kashmiris with psoriasis (study group) and fifty apparently healthy persons coming forward for voluntary blood donation to the hospital (control group )were screened for the presence of HbsAg by Monolisa Ag HbsAg one step enzyme immunoassay technique .The serological estimation of HCV was done by HCD 3.0 in vitro enzyme immunoassay for detection of anti HCV antibody in the serum. Two (4%) of the 50 patients in the study group were sero­positive for HbsAg and one (2%) for anti HCV. Seven (14%) of the control group were sero-positive for HbsAg and none (0%) for anti HCV. The prevalence of HbsAg in the study group comprising Kashmiri patients of psoriasis was lower than in the control group of voluntary blood donors whereas the prevalence of anti HCV was 2% in the study group against nil in the control group.Using the Chi-square test for analysis of data, the null hypothesis applies.It would appear that the prevalence of HbsAg and HCV infections in psoriasis is not statistically significant.


Keywords: Hepatitis, HbsAg, Anti-HCV


How to cite this article:
Ahmad QM, Sameem F, Shah IH. Prevalence of hepatotrophic viruses b&c in psoriasis -A study from kashmir. Indian J Dermatol 2005;50:200-2

How to cite this URL:
Ahmad QM, Sameem F, Shah IH. Prevalence of hepatotrophic viruses b&c in psoriasis -A study from kashmir. Indian J Dermatol [serial online] 2005 [cited 2020 Oct 28];50:200-2. Available from: https://www.e-ijd.org/text.asp?2005/50/4/200/19744



   Introduction Top


The role of Hepatitis B virus(HBV) and Hepatitis C virus(HCV) infection in psoriasis has been the subject of much research in recent years. The extra -hepatic manifestations of HCV including many cutaneous features has been extensively reviewed in literature.[1] The association with psoriasis and psoriatic arthritis has been investigated in a few studies. [2],[3],[4] Some of these studies revealed a higher prevalence of HCV infection in psoriatic arthritis patients.

The prevalence of psoriasis in Kashmir varies from 2.4 to 3.4%.[5],[6] The epidemiology of chronic liver disease in Kashmir shows that 25% are due to HBV and 45% due to HCV infection.[7] ln view of the paucity of data from this part of the world, a study was designed to determine whether any association between HCV and HBV infection and psoriasis exists in the vale of Kashmir.


   Material and methods Top


Fifty Kashmiri patients with psoriasis were recruited into the study between May 2001 to January 2002. These subjects comprised of 50 patients who presented to the Dermatology clinic of SMHS Hospital (associated teaching hospital of Government Medical College, Srinagar ,Kashmir, India). They were recruited after obtaining a verbal consent to participate in the study. The control group was selected consisting of 50 apparently normal individuals coming to the blood bank of SMHS Hospital for voluntary blood donation. Information regarding risk factors for viral hepatitis was obtained in all subjects using a structured questionnaire. Attempt was made to match the control group with psoriasis group for age and gender .All the patients and controls had their sera assayed for the presence of HbsAg and anti HCV by Monolisa Ag HbsAg one step enzyme immunoassay technique and HCD 3.0 in vitro enzyme immunoassay respectively.

The analysis of data was done using the chi-square test.


   Results and analysis Top


The mean age of patients with psoriasis was 35 years, the age range being from 7 to 60 years.The male: female ratio in patients with psoriasis was 1.3:1. Family history was elicited in 13 patients. Thirty patients had chronic plaque type psoriasis, 5 had acute guttate type psoriasis, 2 had psoriatic arthritis, 8 had pustular psoriasis and 5 had erythrodermic psoriasis . The identified risk factors are as shown in [Table - 1] .One patient was both HbsAg and anti HCV positive and also HIV positive and he had recalcitrant erythrodermic type of psoriasis. Two (4%)out of the 50 patients with psoriasis were HbsAg positive and 1(2%)anti HCV positive while 7(14%)out of 50 individuals in the control group were HbsAg positive and none (0%) anti HCV positive .Using the Chi square test ,the observed value for HbsAg and psoriasis is 3.08 and for anti HCV and psoriasis is 1.01.[Figure - 1][Figure - 2] respectively.


   Discussion Top


The age range of psoriasis was from 7 to 60 years. The male : female ratio of 1.3:1 was consistent with the previously reported sex ratio in adults. The age at onset was less than 25 years in 13 females and 10 males and more than 25 years in 19 males and 8 females. This supports the fact that females tend to develop psoriasis earlier than males .One patient was both H0 bsAg and anti HCV positive and also HIV positive and he had recalcitrant erythrodermic type of psoriasis.

In a study carried out by Taglione,Vafferoni and Martin[2], a statistically significant difference was seen between the prevalence of HCV infection in patients with psoriatic arthritis and the general population. Using ELISA for detecting anti HCV antibodies in 50 patients of psoriasis and 50 patients of psoriatic arthritis they detected anti HCV antibodies in 6/50 (12%)patients with psoriatic arthritis, in 5/50(10%)patients with psoriasis and 4/76 (5.2%)patients with rheumatoid arthritis who were used as the control group.

Yamamoto and Katayama [3]analysed the serum of 8 patients of psoriasis associated with hepatitis C virus infection amongst a total of 79 patients. Anti HCV antibodies were detected by ELISA. HCV messenger RNA was demonstrated by reverse transcriptase polymerase chain reaction in tissue sections of lesions of 1 patient of psoriasis and 1 patient of generalized pustular psoriasis, thus proving active viral replication in the skin lesions.

In a Buenos Aires study,[4] 118 patients of psoriasis were studied for viral markers by ELISA antibody. Nine out of 118 patients were positive for anti HCV(p<0.00l%),l.5%(17/113)were anti HBc positive, 64.7%were anti HbsAg positive, 2.5%(3/l7)HbsAg positive and 2.5%(3/17)isolated HBc positive.The author concluded that in the presence of liver disease in psoriasis patients, an HCV infection should be considered as an alternative diagnosis .A significant number of psoriatics showed the presence of HBV markers in the Buenos Aires study. Reports suggest that HBV vaccine could result in the exacerbation and provocation of psoriasis.[8] However treatment with interferons in a patient of HCV infection resulted in eruption or aggravation of psoriatic arthritis attributable to the underlying immunological alteration caused by HCV.

In our setting it was not possible to do the reverse transcriptase polymerase chain reaction for detection of HCV in the skin lesions or to look for the other virological markers like anti HBs,anti HBc or isolated HBc in view of non-availability or cost considerations. Also, in contrast to the study by Taglione, a large patient group of psoriatic arthritis was not included in the study. So, the present study has to be considered in light of these facts. In conclusion, this study did not find a higher prevalence of HBV and HCV infection in patients with psoriasis as compared to the prevalence in apparently healthy normal control. It therefore appears that HBV and HCV infection is not associated with psoriasis in Kashmir. However a larger population based study may help to clarify the findings from this study.

 
   References Top

1.Duotre MS.Hepatitis C virus related skin diseases .Arch Dermatol 1999;135(l l):1401-3.   Back to cited text no. 1    
2.Taglione E,Vatteroni ML,Martin P,Galluzo E,Lombardni F, et al .Hepatitis C virus infection:prevalence in psoriasis and psoriatic arthritis .J Rheumatol 1999;26:370-2.   Back to cited text no. 2    
3.Yamamoto T,Katayana I, Nishioka K.Psoriasis and Hepatitis C virus. Acta Dermatol Venereol 1995;75(6):482-3.   Back to cited text no. 3    
4.Chouela E,Abeldano A,Panetta J,Ducard M, et al. Hepatitis C virus antibody (anti-HCV): prevalence in psoriasis .Int J Dermatol 1996;35(l l):797-9.   Back to cited text no. 4    
5.Masood Q, Hassan I.Pattern of skin disorders in Kashmir valley .Indian J Dermatol 2002;47(3):147-8.   Back to cited text no. 5    
6.Hajini GH,Gupta R.Prevalence of psoriasis in Kashmir.JK Practitioner I 998;5(2): 137-8.   Back to cited text no. 6    
7.Khuroo MS.Viral hepatitis A to G and beyond-a personal perspective.JK Practitioner 2000 ;7( 1 ):4-11.   Back to cited text no. 7    
8.Hepatitis B virus vaccine safety -a report of an international agency group. MMWR 1982;31:465-7.  Back to cited text no. 8    


Figures

[Figure - 1], [Figure - 2]

Tables

[Table - 1]



 

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    Abstract
    Introduction
    Material and methods
    Results and analysis
    Discussion
    References
    Article Figures
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