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Published on: June 7, 2017
Keratoconjunctivitis sicca and chronic HCV infection
D Siagris1, N Pharmakakis, M Christofidou
1Dept. of Internal Medicine, Patras University Hospital, Greece. dsiagris@mland.gr
Background:
The aim of this study was to determine the prevalence of keratoconjunctivitis sicca (KCS) in Greek patients with chronic hepatitis C virus (HCV) infection and its association with HCV genotypes and liver histology.
Patients And Methods:
93 HCVAb (+) patients underwent lacrimal function testing (Schirmer-1 test, break-up time test and Rose-Bengal staining test) and estimation of serum cryoglobulins and autoantibodies. 80 healthy volunteers were included in the study as controls.
Results:
34 out of 93 HCV patients (36.6%) and eight out of 80 healthy subjects (10%) had at least two abnormal lacrimal function tests suggestive of KCS (p < 0.001), cryoglobulinemia was evident in 20 patients (21.5%), rheumatoid factor (RF) in 43 (46.2%), antinuclear antibodies (ANA) in 19 (20.4%), antinuclear antigens (anti-SS-A and anti-SS-B) in one (1.1%) and two (2.2%) patients, respectively. Reduced prevalence of KCS was found in patients with genotype 3a compared to those with other genotypes (5/30, 16.7% vs 20/42, 47.6%, p = 0.007), probably because of their younger age. In patients with KCS a higher staging score was noted in liver biopsy compared to those without KCS (4.50 +/- 1.65 vs 3.06 +/- 1.88, p = 0.005).
Conclusion:
Greek patients with chronic HCV infection have a high prevalence of KCS (36.6%). The low frequency of anti-SS-A and anti-SS-B antibodies in these patients denotes different pathogenetic associations from primary Sjogren's syndrome.
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