Sicca syndrome associated with hepatitis C virus infection

Area of Science:

• Immunology
• Virology
• Rheumatology

Background:

• Sicca syndrome, often associated with Sjögren's syndrome, can have various underlying causes.
• Hepatitis C virus (HCV) infection is a known extrahepatic manifestation that can mimic autoimmune diseases.

Purpose of the Study:

• To determine the prevalence of HCV infection in patients diagnosed with sicca syndrome.
• To characterize the clinical, immunologic, and genetic features of sicca syndrome associated with HCV infection.

Main Methods:

• A prospective study included 62 consecutive patients meeting European criteria for Sjögren's syndrome.
• HCV infection was confirmed by positive recombinant immunoblot assay and detection of viral RNA in serum and saliva.
• Patients were tested for rheumatoid factor, cryoglobulins, antinuclear antibodies, anti-SS-A/SS-B antibodies, and HLA typing was performed.

Main Results:

• HCV infection was identified in 19% of sicca syndrome patients.
• HCV-positive patients showed increased neurologic involvement (24% vs. 4%) and elevated transaminase levels (87.5% vs. 16%).
• Rheumatoid factor and cryoglobulins were more frequent in HCV-positive patients, while anti-SS-A/SS-B antibodies were less common (P < 0.01). Viral RNA was detected in the saliva of 83% of HCV-positive patients.

Conclusions:

• HCV infection is highly prevalent in patients presenting with sicca syndrome.
• HCV-associated sicca syndrome exhibits distinct clinical characteristics, including a lack of anti-SS-A/SS-B antibodies.
• The presence of HCV RNA in saliva suggests a potential role for salivary detection in diagnosing HCV-associated sicca syndrome.