Logo for University of Iowa Health Care This logo represents the University of Iowa Health Care
Meet the Iowa Otolaryngology Research Scholar FellowClick Here

Hepatitis and Salivary Swelling (Viral Sialadenitis)

last modified on: Fri, 11/24/2023 - 07:48

return to: Salivary Swelling


Viruses known to be associated with salivary gland swelling include paramyxovirus (causing mumps), human immunodeficiency virus (HIV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes simplex virus (HHSV-8), hepatitis C virus (HVC), human papilloma virus (HPV), cocksackie virus, influenza virus and echovirus. (Schreiber 2009)

Hepatitis C virus (HCV) infection has been estimated to affect 170 million people worldwide with a prevalence in the United States of ~ 2% of the adult population during the later part of the 20th century (Alter et al 1999). Chronic hepatitis C can lead to cirrhosis and hepatocellular carcinoma.

Extrahepatic manifestations (EHMs) of HCV occur in 40-75% of patients with chronic HCV infectionand demonstrate at least one clinical EHM. Although HCV may effect other cells outside of the liver, most EHMs are thought to be autoimmune as a secondary-host-immune response to the viral infection and not a direct viral effect.

The association between sialadenitis and HCV infection was first reported in 1992 (Haddad 1992) and has been estimated to produce an HCV-related sicca syndrome with chronic HCV with the large range (4 to 57%) ascribed to differences in diagnostic critera. The virus has not been demonstrated to directly infect salivary gtland tissue - and the sialadenitis ascribed to HCV is throught to be due to a host-immune mediated effect (Ko 2012).

A viral etiology to Sjogrens syndrome has been postulated - but inconclusive. The term "Sjogren's syndrome secondary to chronic HCV infection" has been suggested to differentiate between the two entities. (Carrozzo 2008)


Ko HM, Hernandez-Prera JC, Zhu H, Dikman SH, Sidhu HK, Ward SC, thung SN: Morphologic features of extrahepatic manifestation of hepatitis C virus infection. Clin Dev Immunol 2012; 2012740138. doi:10.1155/2012/740138

Alter MJ,  Kruszon-Moran D, nainan OV, et al The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. The New England Journal of Medicine. 1999;3421(8):556-562

Haddad J, Deny P, Munz-Gotheil C, et al. Lymphocytic sialadenitis of Sjogren’s syndrome associated with chronic hepatitis C virus liver disease. The Lancet. 1992;339(8789):321–323

Schreiber A and Hershman G: Non-HIV Viral Infections of the Salivary Glands 2009  in Oral and Maxillofacial Surgery Clinics Volume 21, Issue 3

Carrozzo M: Oral diseases associated with hepatitis C virus infection. Part 1. Sialadenitis and salivary glands lymphoma. Oral Dis. 2008 Mar;14(2):123-30