Paucity of Sjogren-like syndrome in a cohort of HIV-1-positive patients in the HAART era. Part II

Academic Department of Pathophysiology, AIDS Unit, School of Medicine, National and Kapodistrian University of Athens, Greece.
Rheumatology (Impact Factor: 4.48). 11/2003; 42(10):1164-7. DOI: 10.1093/rheumatology/keg316
Source: PubMed

ABSTRACT This study was performed in order to investigate the prevalence of Sjögren-like syndrome (SLS) in the highly active anti-retroviral therapy (HAART) era in a cohort of HIV-1-positive Greek patients.
One hundred and thirty-one unselected patients were screened by the validated European Union (EU) criteria for Sjögren's syndrome. Of the 31 who gave a positive EU-validated questionnaire, 17 consented to undergo minor salivary gland biopsy and other tests.
Only two patients had a positive salivary gland biopsy and both belonged to the non-compliant HAART group, whereas none of the compliant HAART patients had histological findings.
It is concluded that SLS, the prevalence of which in the pre-HAART era was 7.8%, has disappeared, possibly as a result of the protective action of HAART.

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Available from: George Panayiotakopoulos, Sep 22, 2014
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    • "There has been one small experimental study in 16 Sjogren’s syndrome (SJS) patients who were randomized to receive placebo or lamivudine, a reverse transcriptase inhibitor, usually harnessed as part of Highly-Active Antiretroviral Therapy (HAART) for HIV patients [41]. This experimental treatment was given on the basis of observations that the incidence of diffuse infiltrative lymphocytosis syndrome (DILS) has significantly reduced since HAART has been introduced [42]. DILS is an SJS-like illness that affects HIV-infected individuals. "
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    The Open Rheumatology Journal 03/2013; 7:13-21. DOI:10.2174/1874312901307010013
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    • "The condition usually manifests several years after HIV seroconversion and, besides the lymphocitic infiltration of salivary and lachrymal glands, is characterised by lymphocytic interstitial pneumonitis (31%), myositis (26%) and hepatitis (23%) [61]. DILS differs from pSS by the fact that the occurrence of extra-glandular involvement is more frequent, whilst the presence of autoantibodies and rheumatoid factor is observed in a lower number of patients In addition, the two conditions differ in the nature of infiltrating lymphocytes (CD4+ T cells in pSS, CD8+ T cells in DILS) and in the association with different HLA haplotypes [58-60]. "
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    ABSTRACT: A clinical picture of dry eye and dry mouth with the histological counterpart of focal lymphocytic sialoadenitis, usually detected in minor salivary glands, is considered the hallmark of Sjögren's syndrome. The association of sicca complaints and focal sialoadenitis can be also found in a number of other diseases, including some systemic viral infections. Among these conditions, chronic hepatitis C virus infection, associated with mixed cryoglobulinaemia and extra-hepatic manifestations, and HIV infection, particularly in the phase of diffuse interstitial lymphocytic infiltration, may mimic the clinical and histological aspects of Sjögren's syndrome. However, each disorder is characterised by specific, disease-related immunopathological aspects. Besides sicca complaints, the various disorders may also share a number of systemic extra-glandular features and the possible development of mucosa-associated lymphoid tissue lymphomas. This latter event represents in all of these diseases the final result of an antigen-driven chronic stimulation of B lymphocytes.
    Arthritis research & therapy 08/2011; 13(4):233. DOI:10.1186/ar3361 · 3.75 Impact Factor
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    • "A successful HAART reduces viral replication, viral load in the peripheral blood falls to undetectable levels, the number of CD4+ T lymphocytes increases, and finally reconstitution of the immune system occurs. In a follow-up study, the prevalence of HIV-1-related SS dropped from 8% in the pre-HAART era to 1.5% (2 out of 131 patients) after the introduction of HAART [33]. Similar data were reported in a study from the US, where the prevalence of DILS had dropped significantly in the post-HAART era [34]. "
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    ABSTRACT: Circumstantial evidence suggests that retroviruses play a role in the pathogenesis of Sjögren's syndrome. Such evidence, derived from studies of patients with Sjögren's syndrome, includes the following: the presence of serum antibodies cross-reactive with retroviral Gag proteins; the occurrence of reverse transcriptase activity in salivary glands; the detection of retroviral antigens, retrovirus-like particles, or novel retroviral sequences in salivary glands; the occurrence of Sjögren's syndrome-like illnesses in patients having confirmed systematic infections with retroviruses such as human immunodeficiency virus-1 (HIV-1) and human T lymphotropic virus type 1; and the beneficial effect of anti-retroviral treatment on the occurrence of HIV-1-associated sicca syndrome. Additional evidence is provided by animal models.
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