PREVALENCE OF SJOGRENS-LIKE-SYNDROME IN A COHORT OF HIV-1-POSITIVE PATIENTS - DESCRIPTIVE PATHOLOGY AND IMMUNOPATHOLOGY

The aims of the study were (a) to investigate the prevalence of Sjogre n's-like syndrome (SLS) in an unselected population of HIV-1-positive patients and (b) to describe the pathology and immunopathology of the labial minor salivary gland biopsy. Seventy-seven HIV-1-positive patie nts were asked to answer the validated questionnaire of the European p reliminary criteria for the classification of Sjogren's syndrome on or al and ocular sicca symptoms. Twenty-six patients gave one positive an swer to both ocular and oral symptoms, and of these 14 (hepatitis C vi rus negative) consented to participate in the study (patients group). Ten age-and sex-matched HIV-1-positive patients with a negative questi onnaire constituted the control group. Patients and controls had: (a) Schirmer's test and slit-lamp examination after Rose Bengal staining; (b) parotid gland scanning with technetium; (c) detection of autoantib odies in sera to Ro/SSA and La/SSB; (d) labial salivary gland biopsy ( patients group only). The control group gave negative parotid gland sc anning and only one gave a positive Rose Bengal staining test. In the patients group, parotid gland enlargement was manifested by three pati ents and only one gave positive Rose Bengal staining test. Six out of the 14 patients had biopsies identical with Sjogren's syndrome and fiv e of these gave positive parotid gland scanning. In the biopsies of fo ur other patients, mucoid degeneration of the stroma was found. Immuno pathology revealed that the predominant cells were T cells with the CD 8 phenotype. None of the patient and control sera had autoantibodies t o Ro/SSA and La/SSB, whereas all patients had hypergammaglobulinaemia. The overall prevalence of possible SLS in a mixed population of HIV() patients (88.3% men and 11.7% women) was 7.79% which is >2.5 times h igher than that observed in normal Greek adult females.