Sicca syndrome in patients infected with human immunodeficiency virus-1.

We investigated human immunodeficiency virus-1 (HIV-1)-associated sicca syndrome. The average saliva production in HIV-infected patients was 15.9 ± 6.3 ml, and the average tear production was 9.8 ± 4.5 mm. In particular, 6 patients (42.9%) showed a significant decrease in tear production. This sicca syndrome mimicked autoimmune Sjogren's syndrome (SS) because of the presence of dry eye, dry mouth, hyperamylasemia, and hypergammaglobulinemia; however, no antinuclear antibodies, anti-SS-A, or anti-SS-B were detected in sera from HIV-1-infected patients. In addition, no relationship was observed between saliva and tear production and CD4, HIV-RNA. Hepatitis C virus (HCV) and human T-lymphotrophic virus (HTLV-1) are considered to be possible causative agents of SS. However, coinfection with HCV did not affect the decrease of saliva and tear production, and only one patient was coinfected with HTLV-1. Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are also potential causative agents of SS, and they are sometimes detected in the saliva of HIV-1-infected patients. However, the detection of EBV and CMV in the saliva was not related to the decrease in saliva production. Furthermore, HIV therapy (highly active anti-retroviral therapy; HAART) did not affect the state of sicca syndrome.