Hepatitis C virus infection in ‘primary’ Sjögren's syndrome: prevalence and clinical significance in a series of 90 patients

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Abstract
OBJECTIVES To determine the prevalence and clinical significance of hepatitis C virus (HCV) infection in a large cohort of patients with ‘primary’ Sjögren’s syndrome (SS). METHODS 90 consecutive patients (83 female and seven male) were included, with a mean age of 62 years (range 31-80) who prospectively visited our unit. All patients fulfilled the European Community criteria for SS and underwent a complete history, physical examination, as well as biochemical and immunological evaluation for liver disease. Serum from all patients was tested for antibodies to HCV by third generation enzyme linked immunoassay and positivity was confirmed by polymerase chain reaction. RESULTS Antibodies to HCV were present in 13 (14%) patients with ‘primary’ SS. When compared with patients without HCV infection, patients with HCV infection presented a higher prevalence of hepatic involvement (100% v 8%, p < 0.05). Transcutaneous liver biopsy was performed in five patients with HCV infection, and specimens obtained showed in all cases a chronic active hepatitis with varying degrees of portal inflammation. CONCLUSION HCV infection is frequent in patients with ‘primary’ SS and liver involvement is present in all these patients. The possible pathogenic role of HCV infection in these patients is still unclear.