Evidence map›Paper›PMID 40624706›Full record

ArticleArthritis research & therapy2025

Sicca manifestations and lymphoproliferation in hepatitis C virus: effects of direct acting antiviral therapy on dryness and B-cell activity compared to Sjögren's disease.

Amina Maher, Mohamed Tharwat Hegazy, Tareq M Algarf, Manar A Abdul-Aziz, Luca Quartuccio, Naguib Zoheir, Salvatore De Vita, Gaafar Ragab

Abstract readComparative Study
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Article in Arthritis research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Amina MaherInternal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed Tharwat HegazyInternal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.
Tareq M AlgarfDepartment of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Manar A Abdul-AzizOral Pathology Department, Faculty of Oral & Dental Medicine, Cairo University, Cairo, Egypt.
Luca QuartuccioClinic of Rheumatology, Department of Medical Area (DAME), University Hospital "Santa Maria della Misericordia", University of Udine, Udine, Italy.
Naguib ZoheirClinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Salvatore De Vita *Clinic of Rheumatology, Department of Medical Area (DAME), University Hospital "Santa Maria della Misericordia", University of Udine, Udine, Italy.
Gaafar Ragab *Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt. gragab@kasralainy.edu.eg.ORCID 0000-0001-6529-0334

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesHepatitis C virus (HCV) can be associated with sicca manifestations. To study the effect of direct-acting antivirals (DAAs) on sicca manifestations in HCV-infected patients and the difference between those patients and others with HCV without dryness & Sjögren's disease (SjD).

methodsWe studied 60 patients in 3 groups: Group 1 (20 HCV + sicca), group 2 (20 HCV without sicca), and group 3 (20 SjD). Groups 1 and 2 received DAAs according to the Egyptian Ministry of Health protocols and were evaluated before and after treatment. Group 3 was evaluated once. Our study evaluated the patients by both subjective and objective methods.

resultsAll HCV cases had sustained viral response (SVR). Comparing the characteristics of groups 1 (before treatment) & 3: Group 1 had a higher frequency of RF, cryoglobulins, and polyclonal-hypergammaglobulinemia (P-values 0.021, 0.003, and ˂0.001 respectively). Group 3 had higher scores of VAS dry eye, VAS dry mouth, VAS fatigue, and VAS pain than group 1 (P-values ˂0.001 in all). Group 3 also had a higher frequency of Anti-Ro and Anti-La (P-values < 0.001). Group-1 before DAAs treatment had higher markers denoting B-cell hyperactivity [higher Rheumatoid factor (RF), cryoglobulins, and beta2-microglobulins (β2M)] compared to group-2 which improved markedly after SVR. This supports that group 1 is further ahead in the direction of lymphoproliferation. Group 1 patients after SVR showed marked improvement in VAS dry eye, VAS dry mouth, VAS fatigue, VAS pain, ESSPRI, and ESSDAI (P-values ˂0.003, ˂0.002, ˂0.016, ˂0.001, ˂0.002, and ˂0.014 respectively). There was a significant improvement in RF, and serum β2M levels (after SVR), (P-values ˂0.013, and 0.001 respectively). Group 1 is further ahead in the direction of lymphoproliferation than group 2 with higher statistically significant serum β2M and polyclonal serum protein electrophoresis (P-values 0.006 and 0.047 respectively).

conclusionHCV patients with sicca manifestations treated by DAAs showed significant clinical and immunological improvements. The difference between group 1 (before and after SVR) and group 3 supports the notion that they are two different entities, with different characteristic features. Sicca manifestations improved after the eradication of HCV.

Indexed as

Antiviral AgentsB-LymphocytesHepatitis C, ChronicSjogren's SyndromeAdultFemaleHepacivirusHumansMaleMiddle AgedXerostomiaAntiviral AgentsB-cell proliferationDirect-acting antiviral drugsHepatitis C virusSicca manifestationsSjögren’s disease

Identifiers

PMID40624706
PMCPMC12232862

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