Association of Sjögrens Syndrome in Patients with Chronic Hepatitis Virus Infection: A Population-Based Analysis

Abstract

ObjectiveThe association between Sjögren’s syndrome (SS) and chronic hepatitis virus infection is inconclusive. Hepatitis B (HBV) and hepatitis C virus (HCV) infections are highly prevalent in Taiwan. We used a population-based case-control study to evaluate the associations between SS and HBV and HCV infections.Materials and MethodsWe identified 9,629 SS patients without other concomitant autoimmune diseases and 38,516 sex- and age-matched controls without SS from the Taiwan National Health Insurance claims data between 2000 and 2011. We utilized multivariate logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the associations between SS and HBV and HCV infections. Sex- and age-specific (<55 and ≥55 years) risks of SS were evaluated.ResultsThe risk of SS was higher in patients with HCV than in those without chronic viral hepatitis (OR = 2.49, 95% CI = 2.16–2.86). Conversely, HBV infection was not associated with SS (OR = 1.10, 95% CI = 0.98–1.24). Younger HCV patients were at a higher risk for SS (<55 years: OR = 3.37, 95% CI = 2.62–4.35; ≥55 years: OR = 2.20, 95% CI = 1.84–2.62). Men with HCV were at a greater risk for SS (women: OR = 2.26, 95% CI = 1.94–2.63; men: OR = 4.22, 95% CI = 2.90–6.16). Only men with chronic HBV exhibited a higher risk of SS (OR = 1.61, 95% CI = 1.21–2.14).ConclusionHCV infection was associated with SS; however, HBV only associated with SS in men.

Primary Sjogren’s syndrome and the risk of acute pancreatitis: a nationwide cohort study

“…However, the pathogenesis of the association between SS and HCV is not fully known and whether the sicca syndrome in patients with HCV is due to pSS, secondary SS or only SS-like symptoms remains controversial. 18 Moreover, neither correcting HCV in the multivariate Cox model nor the analysis after excluding patients with pSS with prior HCV and their matched controls resulted in different outcome. Thus, the initial study design was not altered and HCV was not excluded.…”

Contribution of HIV Infection, AIDS, and Antiretroviral Therapy to Exocrine Pathogenesis in Salivary and Lacrimal Glands

“…For example, chronic infection by the hepatitis C virus (HCV) is known to induce a number of extrahepatic and rheumatological manifestations [ 133 ]. The prevalence of sicca symptoms has been estimated to affect between 10% to 30% of HCV-infected patients [ 134 , 135 , 136 , 137 , 138 ]. On the other hand, less than 5% of patients with SS are HCV-positive [ 133 ].…”

“…Some studies report that up to 50% of all HCV patients have chronic focal sialoadenitis [ 139 ]. As a result, sicca symptoms are common in this population, though usually less severe when compared to SS [ 137 , 140 , 141 ]. It remains unknown whether the virus causes a disease that mimics SS, or if HCV leads to the development of SS.…”

A functional variant in the OAS1 gene is associated with Sjögren’s syndrome complicated with HBV infection

“…A recent study on the prevalence of HBV infection in patients with SS (603 cases) in Spain showed a slight increase in the percentage of HBV infection in SS patients (HBsAg + 0.83%) compared to the population controls (HBsAg + 0.7%) 31 . Additionally, a study of SS patients from Taiwan (9,629 cases) infected with HBV showed that the HBV infection was more frequent in SS patients (4.3%) than in the healthy population (3.6%, 38,516 controls) 30 . Our data indicated that there is an increased incidence of HBV in SS patients carrying the A allele.…”

“…Of the 350 million individuals worldwide infected with HBV, 33% reside in China 27 . Although there is accumulating evidence indicating that hepatitis C virus (HCV) infection contributes to the etiology of SS 28 , 29 , there is a limited number of reports regarding the nature of the association between SS and HBV infection 30 – 32 . Two large cohort studies have suggested that HBV infection might be more prevalent in patients with SS than in the general population 30 , 31 .…”