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
Abstract Objectives Hepatitis 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)...
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2025-07-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-025-03605-9 |
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| author | Amina Maher Mohamed Tharwat Hegazy Tareq M. Algarf Manar A. Abdul-Aziz Luca Quartuccio Naguib Zoheir Salvatore De Vita Gaafar Ragab |
| author_facet | Amina Maher Mohamed Tharwat Hegazy Tareq M. Algarf Manar A. Abdul-Aziz Luca Quartuccio Naguib Zoheir Salvatore De Vita Gaafar Ragab |
| author_sort | Amina Maher |
| collection | DOAJ |
| description | Abstract Objectives Hepatitis 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). Methods We 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. Results All 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). Conclusion HCV 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. |
| format | Article |
| id | doaj-art-f8e4eb9a50584fa38d3db6dca4b067a4 |
| institution | DOAJ |
| issn | 1478-6362 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | Arthritis Research & Therapy |
| spelling | doaj-art-f8e4eb9a50584fa38d3db6dca4b067a42025-08-20T03:05:13ZengBMCArthritis Research & Therapy1478-63622025-07-0127111010.1186/s13075-025-03605-9Sicca manifestations and lymphoproliferation in hepatitis C virus: effects of direct acting antiviral therapy on dryness and B-cell activity compared to Sjögren’s diseaseAmina Maher0Mohamed Tharwat Hegazy1Tareq M. Algarf2Manar A. Abdul-Aziz3Luca Quartuccio4Naguib Zoheir5Salvatore De Vita6Gaafar Ragab7Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo UniversityInternal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo UniversityDepartment of Otorhinolaryngology, Faculty of Medicine, Cairo UniversityOral Pathology Department, Faculty of Oral & Dental Medicine, Cairo UniversityClinic of Rheumatology, Department of Medical Area (DAME), University Hospital “Santa Maria della Misericordia”, University of UdineClinical and Chemical Pathology Department, Faculty of Medicine, Cairo UniversityClinic of Rheumatology, Department of Medical Area (DAME), University Hospital “Santa Maria della Misericordia”, University of UdineInternal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo UniversityAbstract Objectives Hepatitis 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). Methods We 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. Results All 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). Conclusion HCV 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.https://doi.org/10.1186/s13075-025-03605-9Hepatitis C virusSjögren’s diseaseDirect-acting antiviral drugsB-cell proliferationSicca manifestations |
| spellingShingle | Amina Maher Mohamed Tharwat Hegazy Tareq M. Algarf Manar A. Abdul-Aziz Luca Quartuccio Naguib Zoheir Salvatore De Vita Gaafar Ragab 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 Arthritis Research & Therapy Hepatitis C virus Sjögren’s disease Direct-acting antiviral drugs B-cell proliferation Sicca manifestations |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | sicca manifestations and lymphoproliferation in hepatitis c virus effects of direct acting antiviral therapy on dryness and b cell activity compared to sjogren s disease |
| topic | Hepatitis C virus Sjögren’s disease Direct-acting antiviral drugs B-cell proliferation Sicca manifestations |
| url | https://doi.org/10.1186/s13075-025-03605-9 |
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