title: How hepatitis C virus modifies the immunological profile of Sjögren syndrome: analysis of 783 patients.
abstract: BACKGROUND
  We conducted a study to analyze how infection by hepatitis C virus (HCV) may influence the immunological serum pattern of patients with Sjögren syndrome (SS).
  
  
  METHODS
  Since 1994, we have tested serum HCV-IgG antibodies in 783 patients with SS diagnosed according to the 1993 European classification criteria. The immunological profile at diagnosis was compared according to the presence or absence of HCV.
  
  
  RESULTS
  Of the 783 patients with SS, 105 (13.4 %) tested positive for HCV-IgG antibodies (88 females, 17 males, mean age at SS diagnosis: 62.9 years). Multivariate analysis showed that patients with SS-HCV had a higher mean age and a higher frequency of low C3/C4 levels, cryoglobulins, and hematological neoplasia compared with patients without HCV. The frequency of anti-La antibodies compared with anti-Ro antibodies was higher in patients with SS-HCV (17 % vs. 15 %) and lower in patients without HCV infection (30 % vs. 43 %). The frequency of concomitant detection of the three main cryoglobulin-related markers (cryoglobulins, rheumatoid factor activity, and C4 consumption) was threefold higher in patients with SS-HCV compared with patients without HCV. SS-HCV patients with genotype 1b showed the highest frequencies of immunological abnormalities related to cryoglobulins and the lowest frequencies of anti-Ro/La antibodies.
  
  
  CONCLUSIONS
  We found HCV infection in 13 % of a large series of Spanish patients with SS. The HCV-driven autoimmune response was characterized by a lower frequency of anti-Ro/La antibodies, an abnormal predominance of anti-La among anti-Ro antibodies, and a higher frequency of cryoglobulinemic-related immunological markers in comparison with patients without HCV infection. This immunological pattern may contribute to the poor outcomes found in patients with SS-HCV.
authors.affiliation: Josep Font Autoimmune Diseases Laboratory, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, Barcelona, 08036, Spain. mbrito@clinic.ub.es.|Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain. mbrito@clinic.ub.es.
authors.forename: Pilar
authors.initials: P
authors.lastname: Brito-Zerón
authors.affiliation: Josep Font Autoimmune Diseases Laboratory, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, Barcelona, 08036, Spain. gheitasi@clinic.ub.es.
authors.forename: Hoda
authors.initials: H
authors.lastname: Gheitasi
authors.affiliation: Josep Font Autoimmune Diseases Laboratory, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, Barcelona, 08036, Spain. soleretamozo@hotmail.com.
authors.forename: Soledad
authors.initials: S
authors.lastname: Retamozo
authors.affiliation: Josep Font Autoimmune Diseases Laboratory, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, Barcelona, 08036, Spain. above@ub.edu.
authors.forename: Albert
authors.initials: A
authors.lastname: Bové
authors.affiliation: Viral Hepatitis Unit, Liver Unit, CIBERehd, Hospital Clínic, University of Barcelona, IDIBAPS, C/ Villarroel 170, Barcelona, 08036, Spain. mlondono@clinic.ub.es.
authors.forename: María
authors.initials: M
authors.lastname: Londoño
authors.affiliation: Viral Hepatitis Unit, Liver Unit, CIBERehd, Hospital Clínic, University of Barcelona, IDIBAPS, C/ Villarroel 170, Barcelona, 08036, Spain. sanchez@clinic.ub.es.
authors.forename: Jose-Maria
authors.initials: JM
authors.lastname: Sánchez-Tapias
authors.affiliation: ENT Department, Hospital Clínic, University of Barcelona, IDIBAPS, C/ Villarroel 170, Barcelona, 08036, Spain. mcaba@clinic.ub.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Caballero
authors.affiliation: Primary Care Research Group, IDIBAPS, Primary Care Centre Les Corts, CAPSE, Mejia Lequerica, s / n, Barcelona, 08028, Spain. belchin3541@gmail.com.
authors.forename: Belchin
authors.initials: B
authors.lastname: Kostov
authors.affiliation: Viral Hepatitis Unit, Liver Unit, CIBERehd, Hospital Clínic, University of Barcelona, IDIBAPS, C/ Villarroel 170, Barcelona, 08036, Spain. xforns@clinic.ub.es.
authors.forename: Xavier
authors.initials: X
authors.lastname: Forns
authors.affiliation: Immunopathology and Therapeutic Immunointervention, Centre de Recherche des Cordeliers, INSERM, 15 Rue de l'Ecole de Medecine, Paris, F-75006, France. Srini.kaveri@crc.jussieu.fr.
authors.forename: Srini V
authors.initials: SV
authors.lastname: Kaveri
authors.affiliation: Josep Font Autoimmune Diseases Laboratory, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, Barcelona, 08036, Spain. mramos@clinic.ub.es.|Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain. mramos@clinic.ub.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramos-Casals
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology; D001324:Autoantigens / Q000097:blood / Q000276:immunology; D015331:Cohort Studies; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D003450:Cryoglobulins / Q000378:metabolism; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology* / Q000502:physiology; D006526:Hepatitis C / Q000097:blood / Q000276:immunology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology*; D054884:Host-Pathogen Interactions / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012261:Ribonucleoproteins / Q000097:blood / Q000276:immunology; D012859:Sjogren's Syndrome / Q000097:blood / Q000276:immunology* / Q000821:virology; D000097585:SS-B Antigen
chemical_list: D000974:Antibodies, Antinuclear; D001324:Autoantigens; D003176:Complement C3; D003181:Complement C4; D003450:Cryoglobulins; D018937:Hepatitis C Antibodies; D007074:Immunoglobulin G; D012261:Ribonucleoproteins; D000097585:SS-B Antigen; C035356:SS-A antibodies