title: Chronic hepatitis B virus infection in Sjögren's syndrome. Prevalence and clinical significance in 603 patients.
abstract: OBJECTIVE
  To analyze the prevalence and clinical characteristics of chronic hepatitis B virus (HBV) infection in a large series of patients with Sjögren syndrome (SS).
  
  
  METHODS
  We investigated the prevalence of chronic HBV infection in 603 consecutive patients with SS diagnosed in our department between 1994 and 2008. There were 517 patients with primary SS (482 women and 35 men, with a mean age at the time of fulfillment of the classification criteria of 57 years) and 86 patients with SS associated with chronic HCV infection (66 women and 20 men, with a mean age at the time of fulfillment of the classification criteria of 65 years). All patients fulfilled 4 or more of the 1993 European Community Study Group criteria for SS.
  
  
  RESULTS
  The presence of HBsAg+ was detected in five (0.83%) of the 603 patients with SS. All HBsAg+ patients had primary SS. No patient with HCV-related SS had HBV coinfection. There were 4 women and 1 man, with a mean age at diagnosis of primary SS of 65 years (range 31 to 89 years). All patients showed sicca and systemic involvement. The main extraglandular feature was articular involvement in 5 (100%) patients (including arthritis in two). The main immunologic features were RF in 4 (80%) patients and ANA in 3 (60%). No patient had hypocomplementemia, cryoglobulinemia, antimitochondrial or anti-LKM1 antibodies. Liver involvement was detected in two patients and consisted of slightly raised levels of transaminases. No patient showed clinical manifestations of liver disease such as hepatomegaly, splenomegaly, jaundice or clinical features of hepatic decompensation (ascites, encephalopathy or gastrointestinal bleeding).
  
  
  CONCLUSIONS
  We found a prevalence of chronic HBV infection of 0.83% in SS, very similar to the prevalence in general population in Spain (0.7%). In contrast to the close association between SS and HCV, chronic HBV infection is not associated with SS in our geographical area, with a ratio SS-HBV/SS-HCV cases of 1:10.
authors.affiliation: Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Marcos
authors.forename: Fausto
authors.initials: F
authors.lastname: Alvarez
authors.forename: Pilar
authors.initials: P
authors.lastname: Brito-Zerón
authors.forename: Albert
authors.initials: A
authors.lastname: Bove
authors.forename: Marta
authors.initials: M
authors.lastname: Perez-De-Lis
authors.forename: Candido
authors.initials: C
authors.lastname: Diaz-Lagares
authors.forename: Jose-Maria
authors.initials: JM
authors.lastname: Sanchez-Tapias
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramos-Casals
mesh_terms: D000368:Aged; D003165:Complement System Proteins / Q000032:analysis; D003449:Cryoglobulinemia; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012217:Rheumatoid Factor / Q000097:blood; D016036:Seroepidemiologic Studies; D012859:Sjogren's Syndrome / Q000097:blood / Q000150:complications*; D013030:Spain / Q000453:epidemiology
chemical_list: D006514:Hepatitis B Surface Antigens; D003165:Complement System Proteins; D012217:Rheumatoid Factor