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.

Maillefert JF, Muller G, Falgarone G, Bour JB, Ratovohery D, Dougados

M, Tavernier C, Breban M.

Department of Rheumatology, Rene Descartes University, AP-HP, Cochin

Hospital, Paris, France.

BACKGROUND: 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.

PMID: 12079907 [PubMed - indexed for MEDLINE]

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