Hepatitis C and ocular surface disease.
OBJECTIVE
To assess the frequency of changes in the ocular surface and the presence of hepatitis C virus (HCV) in tear samples of patients with chronic HCV infection.


METHODS
Prospective, nonrandomized, clinical, interdisciplinary, single-center study.


METHODS
Seventy-one patients with previously untreated chronic HCV infection and a control group consisting of 66 patients without systemic HCV infection were enrolled in the trial. The patients with HCV infection were screened for ocular symptoms, visual acuity, and ocular changes. Tear production was measured by the Jones test. Conjunctival impression cytologic analysis was performed. The presence of HCV ribonucleic acid (RNA) in tear and blood samples was determined by quantitative polymerase chain reaction.


RESULTS
On examination, systemic HCV infection was present for a median of 30 months. Fifty percent of all HCV patients showed a decrease in tear production measured by the Jones test. Apart from epithelial changes related to dry eye syndrome in 12 patients, two patients presented mild peripheral corneal thinning. Polymerase chain reaction analysis detected HCV RNA in five (10%) of 52 tear samples. HCV RNA levels in tear samples (mean, 1.0 x 10(4) copies/ml) were considerably lower than in blood samples (mean, 5.3 x 10(5) copies/ml).


CONCLUSIONS
Dry eye syndrome is the most frequently observed ocular feature in HCV infection. Patients with HCV infection (age range, 21 to 60 years) compared with the controls had a significant lower tear production (P = .05). The presence of HCV RNA in 10% of tear samples emphasizes the potential risk of viral transmission through tears.
Jacobi
Christina
C
Department of Ophthalmology, University of Erlangen, Erlangen, Germany. christina.jacobi@augen.imed.uni-erlangen.de
Wenkel
Hartmut
H
Jacobi
Arnd
A
Korn
Klaus
K
Cursiefen
Claus
C
Kruse
Friedrich E
FE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D016174:Hepacivirus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis*; D013666:Tears / Q000821:virology*
D012367:RNA, Viral