Background Chronic HCV infection is a systemic disease and is often associated with various autoimmune disorders.
Objectives The aim of the study is to evaluate the presence of rheumatic autoimmune diseases among chronic hepatitis C virus (HCV) infected patients and to compare the different clinical and immunological patterns of HCV concomitant arthritis.
Methods A descriptive, cross-sectional analysis of patients with HCV infection and concomitant rheumatic complaints was performed in two tertiary care hospitals with national addressability, a Rheumatology and an Infectious Diseases Center. We analyzed the prevalence of systemic autoimmune diseases in chronic HCV infected patients and we comparatively studied two groups: patients with HCV-associated arthritis (the comorbidity), and patients with HCV infection and concomitant rheumatoid arthritis (RA). We used SPSS-Statistics 22., Pearson correlation coefficient and Hi2 test of interdependency.
Results The study group included 90 patients, 66 (73.3%) female patients and 24 (26, %) male patients, most of whom in the 51-60s years of age group- 33 (36.6%) patients. The rheumatic autoimmune disease most frequent encountered was RA, in 36 (40%) patients, followed by spondyloarthritis found in 7 (7.77%) patients, systemic lupus erythematosus in 4 (4.44%) patients, systemic sclerosis, adult onset Still- disease found in 2 (2.22%) cases each. As for the comparative analysis, it included a total of 75 patients, 36 in the concomitant RA group and 39 in the HCV-related arthritis group. The main differences in immunologic features were the predominance (33%) and higher titers of anti-citrullinated protein antibodies (ACPA) (20.9 (0-2673) as compared to 0 (0-1.4)), and of rheumatoid factor (RF) in (72%) with higher titers as compared to (2.8 (0-20)) in the RA and HCV-arthritis respectively. (p<0.001). Cryoglobulins were encountered in 4 patients only in the HCV-related arthritis group. Anti SS-A and anti SS-B antibodies were found in 10 (9%) of patients.
Conclusions In the selected cohort of patients admitted to the Rheumatology and Infectious Diseases Hospitals, rheumatoid arthritis, followed by spondyloarthritis were the systemic autoimmune disease mostly encountered. The anti-citrullinated protein antibodies, rheumatoid factor, anti SS-A and antiSS-B antibodies are important immunological features in patients with HCV and concomitant rheumatic complaints.
Ramos-Casals M1, Muñoz S, Medina F, Jara LJ, Rosas J, Calvo-Alen J, Brito-Zerόn P, Forns X, Sánchez-Tapias JM; HISPAMEC Study Group Systemic autoimmune diseases in patients with hepatitis C virus infection: characterization of 1020 cases (The HISPAMEC Registry). J Rheumatol. 2009 Jul;36(7):1442-8. doi: 10.3899/jrheum.080874. Epub 2009 Apr 15.
Disclosure of Interest None declared