AB0529 SICCA SYNDROME DURING CHRONIC HEPATITIS C: PREVALENCE AND CHARACTERISTICS

Abstract

Background: The prevalence of Sicca Syndrome (SS) in patients with Chronic Hepatitis C (CHC) ranges from 5% to 33%. A link between hepatitis C virus (HCV) and SS was evoked given the strong association of these two pathologies with mixed cryoglobulinemia (MC) on one hand and with the salivary tropism of HCV on the other hand. Objectives: To study the prevalence and the characteristics of Sicca Syndrome during CHC. Methods: All patients suffering from CHC followed over a period of 11 years (2002 - 2012) were retrospectively included. Only patients having clinical SS (xerostomia and/or xerophthalmia) were selected. We have analyzed all data concerning the patient, the hepatitis and the SS. Results: Two hundred and four patients affected by CHC were included. A clinical SS was found in 17 patients (8.39%). There were 15 women and 2 men with an average age of 45.6 years. A High viral load and an advanced hepatic fibrosis were respectively found in 94 and 88% of cases. Cryoglobulinemia and antinuclear antibodies were found in 37.5% and 53% of patients, respectively. Four patients (3 women and 1 man) had also presented the criteria of Sjogren Syndrome. Their average age was 47 years. MC was positive in all 4 patients whereas anti-SSA and anti-SSB were absent in the 4 patients. Biopsy of accessory salivary glands revealed the presence of a grade 4 lymphocytic sialadenitis according to the Chisholm and Masson classification in 3 patients, while the remaining case had a lymphocyte grade 2 sialadenitis. The evaluation of hepatic fibrosis did not reveal cirrhosis in the 4 cases. Conclusion: The prevalence of Sicca syndrome during hepatitis C is estimated at 8% in our study. It was mainly reported in women with perimenopausal age and seems to be associated with cryoglobulinemia, a high viral load and and an advanced fibrosis.