Background The role of hepatitis B virus (HBV) infection in patients with Sjögren’s syndrome (SS) remains unclear. Recent studies suggest that the type I IFN system plays an important role in the pathogenesis of SS. However, no study reveals the ability of type I IFN(mainly IFN-α) in SS patients to resist viruses such as HBV.
Objectives To investigate the prevalence and clinical features of liver involvement of chronic hepatitis B virus infection in patients with SS in southern China, and to evaluate its association with IFN-α.
Methods 410 inpatients with SS diagnosed in our department between 1998 and 2012 were retrospectively investigated for their positive rate of HBsAg, compared with 2050 age- and gender-matched general individuals. There were 320 (288 female and 32 male) patients with primary SS (pSS), 80 (76 female and 4 male)with secondary SS, 5 (3 female and 2 male) with SS associated with HCV infection and 5 (3 women and 2 men) with SS associated with malignant lymphoma. Furthermore, serum IFN-α levels among pSS patients were detected by ELISA, compared with general individuals.
Results There were 11 patients with HBsAg-positive detected in all SS patients. 7 (5 female and 2 male) patients had primary SS, while 3 (female) had SS secondary to rheumatoid arthritis. One patient (female) had HBV/HCV coinfection. The total HBsAg+ rate (2.68%, 11/410) was significantly lower than that of the matched controls(12.34%, 253/2050, P < 0.05). The prevalence of HBsAg in both primary SS patients(2.19%, 7/320) and secondary SS patients(3.75%, 3/80) was also lower compared with controls (P < 0.05). The main immunologic features were RF in 8 (72.7%) patients, ANA and anti-Ro/SSA antibodies in 7(63.6%), and anti-La/SSB antibodies in 3 (27.3%). Liver involvement was observed in 8 patients (72.7%, 8/11) and consisted of the presence of elevated liver enzymes and/or jaundice and/or coagulation disorders. One patient with HBV/HCV coinfection showed cirrhosis. Five pSS patients with HBsAg+(71.4%, 5/7) developed liver dysfunction, which was significantly different from the 16.6%(52/313) of pSS patients with HBsAg- (P <0.01). In addition, we found significantly increased IFN-α levels in pSS patients.
Conclusions The prevalence of chronic HBV infection in SS patients (both primary and secondary) was lower than that in general population in southern China. But the incidence of liver involvement in pSS patients with HBsAg+ was higher than that of HBsAg-. The characteristic IFN signatures in SS may be conducive to the subsequent clearance of HBV after infection.
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Disclosure of Interest None Declared
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