RESEARCH - Absence of CCP antibody in nonarthritic patients with chronic hepatitis C infection

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J Rheumatol. 2005 Mar;32(3):489-93.

Absence of cyclic citrullinated peptide antibody in nonarthritic patients

with chronic hepatitis C infection.

Lienesch D, R, Metzger A, Debuys P, Sherman K.

Department of Medicine, University of Cincinnati College of Medicine,

Cincinnati, Ohio, USA. lienesd@...

OBJECTIVE: The increased prevalence of rheumatoid factor (RF) in patients

with chronic hepatitis C virus (HCV) infection markedly diminishes the

diagnostic specificity of serum rheumatoid factor (RF) for rheumatoid

arthritis (RA) in patients with HCV. Cyclic citrullinated peptide (CCP)

antibody, a highly specific biomarker for RA in the general population, may

have better diagnostic utility for RA in the HCV population. To investigate

if CCP antibody retains its specificity for RA in HCV infection, we

determined the prevalence of CCP antibodies and examined the relationship

between RF production and CCP antibody levels in a population of

nonarthritic patients with chronic HCV infection. METHODS: CCP antibody and

IgM, IgG, and IgA RF isotypes were determined by ELISA in serum from

nonarthritic patients with chronic HCV infection. RESULTS: In a series of 50

HCV patients, IgG-RF, IgM-RF, and IgA-RF were detectable in 52%, 26%, and

14%, respectively, with a total seropositivity rate of 54%. Marginally

elevated CCP antibody was detected in a single patient (2%). By regression

analysis, serum levels of CCP antibodies did not correlate with RF levels.

CONCLUSION: In contrast to RF, CCP antibody is not increased in HCV

infection. CCP antibody may have improved utility for the diagnosis of RA in

this patient population.

PMID: 15742441

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