The role of hepatitis B virus (HBV)
infection in patients with primary Sjögren's syndrome (pSS) remains unclear. Therefore, we investigated the prevalence and clinical significance of HBV
infection in Taiwanese patients with pSS. One hundred seventy-five patients with pSS who fulfilled the 2002 American-European Revised Classification Criteria were enrolled. Eighteen (10.3%) patients were positive for
hepatitis B surface antigen (
HBsAg). There were 4 males and 14 females, with the mean age of 54.4 years. The main immunological feature was
rheumatoid factor (13 of 18, 72.2%), which was significantly higher than those negative for
HBsAg (28.1%, p < 0.001). Twelve (66.7%) patients developed
liver dysfunction, which was significantly different from the 15.3% of patients who were negative for
HBsAg (p < 0.001). There was no significant difference in extraglandular features between patients positive and negative for
HBsAg, except patients positive for
HBsAg had a lower rate to develop pulmonary involvement than those negative for
HBsAg (5.6% vs. 29.9%, p = 0.027). The mortality rate of pSS patients positive for
HBsAg during follow-up was 12.0% and the presence of HBV
infection did not influence the survival rate (p = 0.730). pSS patients with
liver cirrhosis presented shorter median overall survival compared to those with without
liver cirrhosis (p < 0.001). Our findings suggest that HBV
infection may protect individuals from pSS and reduce pulmonary involvement.