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C. Jacobi, H. Wenkel, K. Korn, F. E. Kruse; Hepatitis C and Ocular Surface Disease. Invest. Ophthalmol. Vis. Sci. 2007;48(13):369.
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© ARVO (1962-2015); The Authors (2016-present)
About 70% of all chronic viral hepatitis is caused by the hepatitis C virus (HCV). The aim of this prospective, interdisciplinary clinical trial was to assess the frequency of changes in the ocular surface and the presence of HCV in tear samples of patients with chronic HCV infection.
71 patients with previously untreated chronic HCV infection and a control group consisting of 66 patients without systemic HCV infection were enrolled in the trial. The patients were devided into three age groups. Only patients over the age of 18 were included in the trial. The following characteristics were studied in the patients with chronic hepatitis C: gender, age, source of infection, estimated duration of infection and presence of HCV infected family members. These patients were screened for ocular complaints, visual acuity and ocular changes. Tear production was measured with the Jones Test. Conjunctival impression cytology was performed. The presence of HCV-RNA in tear and blood samples was determined by quantitative polymerase chain reaction.
Symptoms and signs: Upon examination, systemic HCV infection was present for a median of 30 months. 22 patients (31%) complained of burning and painful eyes. 7 patients (10%) suffered from glare. 19 patients (27%) described pruritus, epiphora and a sensation of pressure. 22 patients (31%) took NSAID`s and 10 patients (14%) used artifical tears. Tear status: 50% of all HCV patients showed a decrease in tear production measured by Jones test. Apart from epithelial changes related to dry eye syndrom in 12 patients, two patients presented mild peripheral corneal thinning. PCR detected HCV-RNA in 5/52 tear samples. HCV-RNA levels in tear samples (mean 1.0 x 104 copies/ml) were considerably lower than in blood samples (mean 5.3 x 105 copies/ml).
Dry eye syndrom is frequently observed in the context of HCV infection. Patients with HCV infection (age 21-60) compared to the control group had a significantly lower tear production (p=0.05). The presence of HCV-RNA in 10% of tear samples emphasizes the potential risk of viral transmission through tears.
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