Hepatitis C virus infection and primary Sjögren's Syndrome: A clinical and serologic description of 9 patients

Objective: To define the clinical and immunologic profile of 9 patients with Sjögren's Syndrome (SS) and Hepatitis C virus (HCV) infection. Patients: 9 out of 305 patients with SS, diagnosed according to the criteria proposed in 2002, had repeated positive serology for HCV. Results: 9 female patients were studied. The mean age at onset of SS was 59 years, with a mean period of follow-up of 7.1 years. All the patients had glandular manifestations and they were all positive for dacryologic tests. Salivary gland biopsy was performed in 4 patients, all showing characteristic lymphocytic infiltrate. The main extraglandular features were arthralgias, photosensitivity, purpura, thyroiditis. All the patients were positive for anti-nuclear antibodies (ANA): 6 anti-Ro/SSA, 3 anti-Ro/SSA and anti-La/SSB positive. HCV-positive SS were compared with 296 patients with primary SS. They showed higher mean age (p = 0.01), higher prevalence of photosensitivity (p = 0.0266) and circulating cryoglobulins (p = 0.0372). In primary SS, most patients had anti-Ro/SSA antibodies alone (49.8%) or associated to anti-La/SSB (46.5%). Five patients (1.8%) had other ANA specificities. Conclusions: A chronic HCV infection is concomitant in about 3% of patients with pSS. They differ from patients without HCV infection for the higher prevalence of photosensitivity and cryoglobulins, without clinical manifestations of cryoglobulinemia.