title: Chronic hepatitis C infection and sicca syndrome: a clear association with HLA DQB1*02.
abstract: BACKGROUND
  Hepatitis C virus infection is a major cause of nonA, nonB hepatitis worldwide. A high prevalence of immunological abnormalities has been shown to occur in patients with chronic hepatitis C virus infection.
  
  
  OBJECTIVE
  The aim of this study was to assess the development of sicca syndrome in a cohort of patients infected with a single strain of hepatitis C virus, namely genotype 1b, and correlate this with viral persistence and human leukocyte antigen type of the patients.
  
  
  METHODS
  Ninety-five patients infected with the single strain hepatitis C virus were used in this study, 32 of whom were polymerase chain reaction-negative and 63 polymerase chain reaction-positive. Patient details were reviewed for symptoms consistent with sicca syndrome. Human leukocyte antigen class I (A, B and C) and class II (DRB and DQB1) typing was performed on all patients. Auto-antibodies were also measured.
  
  
  RESULTS
  DQB1*02 was highly significantly associated with viral persistence (P<0.0001). Nineteen of 21 patients with sicca syndrome were hepatitis C virus-polymerase chain reaction-positive demonstrating a strong association with viral persistence and the development of the syndrome. Human leukocyte antigen DQB1*02 was significantly associated with the development of sicca syndrome, P=0.02.
  
  
  CONCLUSIONS
  The development of autoimmune disease in patients with chronic hepatitis C virus infection depends on the interaction of multiple factors. This study suggests that important factors in this process are viral persistence and human leukocyte antigen type of the patients.
authors.affiliation: Department of Clinical Medicine, St James' Hospital, Dublin, Ireland. clairesmyth@eircom.net
authors.forename: Claire M
authors.initials: CM
authors.lastname: Smyth
authors.forename: Susan M
authors.initials: SM
authors.lastname: McKiernan
authors.forename: Richard
authors.initials: R
authors.lastname: Hagan
authors.forename: Ruth
authors.initials: R
authors.lastname: Pilkington
authors.forename: Myra
authors.initials: M
authors.lastname: O'Regan
authors.forename: Emer
authors.initials: E
authors.lastname: Lawlor
authors.forename: Dermot
authors.initials: D
authors.lastname: Kelleher
mesh_terms: D005260:Female; D006683:HLA-DQ Antigens / Q000276:immunology*; D059866:HLA-DQ beta-Chains; D006684:HLA-DR Antigens / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D012859:Sjogren's Syndrome / Q000150:complications / Q000276:immunology* / Q000821:virology; D019562:Viral Load
chemical_list: D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D006684:HLA-DR Antigens