Prevalence of hepatitis C virus infection in patients with rheumatoid arthritis

July 2, 2002

Ann Rheum Dis 2002 Jul;61(7):635-637

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 Department of Rheumatology, General Hospital,

Dijon University Hospital, Dijon, France Laboratory of Virology, Bocage

Hospital, Dijon University Hospital, Dijon, France Department of

Bacteriology, AP-HP, Cochin Hospital, Paris, France.

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.

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