Prevalence of hepatitis C virus infection in patients with rheumatoid arthritis

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Prevalence of hepatitis C virus infection in patients with

rheumatoid arthritis

ABSTRACT

Backround: Various viruses have been implicated in the cause and

pathogenesis of rheumatoid arthritis (RA). Hepatitis C virus (HCV)

infection, which has been recognised as a cause of some autoimmune

diseases, and which has been described as sometimes presenting with

rheumatic manifestations indistinguishable from RA, might be a

candidate.

Objective: To evaluate the prevalence of HCV infection in patients

with RA.

Methods: Consecutive patients with RA admitted to hospital in two

departments of rheumatology were prospectively studied. Patients'

serum samples were screened for the presence of anti-HCV antibodies.

Patients with positive serology were further evaluated for the

presence of HCV ribonucleic acid by reverse transcriptase polymerase

chain reaction (RT-PCR).

Results: 309 patients (232 women, 77 men, mean age (SD) 54.1 (14.8)

years) were studied. Their mean (SD) disease duration was 74.1 (91)

months. Tests for rheumatoid factors and antinuclear antibodies were

positive in 213 (69%) and 114 (37%) of the patients respectively.

Systemic vasculitis was found in 12 (4%) of the patients. Mean

erythrocyte sedimentation rate was 36.4 (SD 30.5) mm at the first

hour (normal <10 mm) and C reactive protein was 36.8 (SD 45.8) mg/l

(normal range <5 mg/l), respectively, with 181(58.6%) of patients

considered as having active disease. Aspartate transaminases were

increased in 14 (4%) patients, and alkaline phosphatase in 14 (4%).

A positive anti-HCV serology was found in two (0.65%) patients,

including one with a previously diagnosed HCV infection. HCV RNA was

positive by RT-PCR in one of those two patients.

Conclusion: A 0.65% prevalence of past or active HCV infection was

found in patients with RA, which did not differ from the prevalence

of HCV in the general French population. This result does not

support the participation of HCV infection in the pathogenesis of

RA.