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Abstract
Objective: In most of the studies which analyzed the presence of HCV RNA in saliva from patients with chronic hepatitis C only stimulated saliva samples have been used for viral detection. Thus, this study compared the prevalence of HCV RNA in non-stimulated and stimulated salivary flows in patients with chronic hepatitis C. Design: Saliva samples of non-stimulated and stimulated salivary flows from 24 patients were collected, and the HCV RNA was investigated by RT-nested PCR. Data regarding age, gender, risk factors for HCV infection, xerostomia and hyposalivation were also analyzed. Results: The HCV RNA could be detected in 11 (45.8%) non stimulated and in 14 (58.3%) stimulated saliva samples, without statistical significance (p=0.472). However, in 18 (75.0%) patients it was possible to detect the presence of the HCV RNA at least in one of the saliva samples. Six (25.0%) patients complained of xerostomia and nine (37.5%) presented hyposalivation, but in only 3 (12.5%) patients, these conditions could be observed, simultaneously. No significant correlation between the presence of HCV RNA in saliva and age, gender, risk factors for HCV infection, xerostomia and hyposalivation could be identified. Conclusion: Both stimulated and non-stimulated saliva samples must be investigated for the presence of HCV RNA in patients with chronic hepatitis C, to avoid underestimated prevalence of HCV in this group of patients.
Highlights
Hepatitis C Virus (HCV) infection is a major cause of chronic liver disease and liver-related morbidity and mortality worldwide and it is the most prevalent reason for liver transplants in Europe and in the USA [1].Up to 74% of the HCV-infected patients may develop at least one Extra Hepatic Manifestation (EHM) during the course of the infection, such as salivary gland disorders, being the HCV considered as a sialotropic virus [2,3,4,5,6]
In 18 (75.0%) patients it was possible to detect the presence of the HCV RNA at least in one of the saliva samples
No significant correlation between the presence of HCV RNA in saliva and age, gender, risk factors for HCV infection, xerostomia and hyposalivation could be identified
Summary
Hepatitis C Virus (HCV) infection is a major cause of chronic liver disease and liver-related morbidity and mortality worldwide and it is the most prevalent reason for liver transplants in Europe and in the USA [1].Up to 74% of the HCV-infected patients may develop at least one Extra Hepatic Manifestation (EHM) during the course of the infection, such as salivary gland disorders, being the HCV considered as a sialotropic virus [2,3,4,5,6]. In a recent study conducted with Brazilian patients, Grossmann et al [9] detected the HCV RNA in 39.0% of the non-stimulated saliva samples in patients with serum positive HCV RNA. These discrepancies may be due to the heterogeneity of the study design, population studied as well as different methodologies used as saliva sampling methods. Xerostomia in patients with chronic Hepatitis C ranges from 10 to 20% [2,10] and its association with an objective evidence of salivary gland dysfunction like hyposalivation has been described in previous literature [11,12]. It has been suggested that whole saliva could be used as a screening test for identifying a suspected exocrine hypofunction and an abnormality in the salivary gland, such as the Sjögren Syndrome [13]
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