Marcos Miguel, Alvarez Fausto, Brito-Zerón Pilar, Bove Albert, Perez-De-Lis Marta, Diaz-Lagares Candido, Sanchez-Tapias Jose-Maria, Ramos-Casals Manuel
Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.
Autoimmun Rev. 2009 Jun;8(7):616-20. doi: 10.1016/j.autrev.2009.02.007. Epub 2009 Feb 12.
To analyze the prevalence and clinical characteristics of chronic hepatitis B virus (HBV) infection in a large series of patients with Sjögren syndrome (SS).
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.
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).
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.
分析大量干燥综合征（SS）患者中慢性乙型肝炎病毒（HBV）感染的患病率及临床特征。
我们调查了1994年至2008年间在我科确诊的603例连续性SS患者中慢性HBV感染的患病率。其中有517例原发性SS患者（482例女性和35例男性，达到分类标准时的平均年龄为57岁）以及86例与慢性丙型肝炎病毒（HCV）感染相关的SS患者（66例女性和20例男性，达到分类标准时的平均年龄为65岁）。所有患者均符合1993年欧洲共同体研究组制定的4条或更多条SS标准。
603例SS患者中有5例（0.83%）检测到HBsAg阳性。所有HBsAg阳性患者均为原发性SS。没有与HCV相关的SS患者合并HBV感染。有4例女性和1例男性，原发性SS诊断时的平均年龄为65岁（范围31至89岁）。所有患者均有口干眼干及全身受累表现。主要的腺外表现是5例（100%）患者有关节受累（其中2例为关节炎）。主要的免疫学特征是4例（80%）患者有类风湿因子（RF）阳性，3例（60%）患者抗核抗体（ANA）阳性。没有患者有低补体血症、冷球蛋白血症、抗线粒体或抗肝肾微粒体1型抗体。2例患者检测到肝脏受累，表现为转氨酶水平轻度升高。没有患者出现肝病的临床表现，如肝肿大、脾肿大、黄疸或肝失代偿的临床特征（腹水、肝性脑病或胃肠道出血）。
我们发现SS中慢性HBV感染的患病率为0.83%，与西班牙普通人群的患病率（0.7%）非常相似。与SS和HCV之间的密切关联不同，在我们所在地区慢性HBV感染与SS无关，SS-HBV/SS-HCV病例比为1:10。
