RESEARCH - Usefulness of anti-CCP antibodies in patients with hepatitis C

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Clin Rheumatol. 2008 Apr;27(4):463-7. Epub 2007 Sep 18.

Usefulness of anti-CCP antibodies in patients with hepatitis C virus

infection with or without arthritis, rheumatoid factor, or

cryoglobulinemia.

Liu FC, Chao YC, Hou TY, Chen HC, Shyu RY, Hsieh TY, Chen CH, Chang DM, Lai JH.

Division of Rheumatology/Immunology/Allergy, Tri-Service General

Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung

Road, Neihu 114, Taipei, Taiwan, Republic of China.

The presence of antibodies to cyclic citrullinated peptide (CCP) has

high specificity in the diagnosis of rheumatoid arthritis (RA).

Hepatitis C virus (HCV) infection may induce extra-hepatic

manifestations, such as polyarthritis that mimic RA. The aim of this

study was to determine the prevalence of anti-CCP antibodies in

HCV-infected patients with or without arthritis, rheumatoid factor

(RF), or cryoglobulinemia and to investigate whether anti-CCP

antibodies may be helpful in discriminating patients with RA from

patients with HCV-associated arthropathy. A total of 44 patients with

RA, 34 patients with HCV infections, and 42 control patients with

non-RA rheumatic diseases were recruited for the study. Anti-CCP

antibody levels were determined by enzyme-linked immunosorbent assay.

We found that, consistent with other reports, patients with RA were

more likely to have high titers of anti-CCP antibody than HCV-infected

or control patients. A significant number of HCV-infected patients

with neither RF nor cryoglobulinemia were also positive for anti-CCP

antibodies (the three positive values were 36.10, 8.65, and 5.83 U/ml,

P < 0.01 compared with the control patients). The presence of

cryoglobulinemia and/or RF in HCV-infected patients did not affect the

anti-CCP outcomes. Although anti-CCP antibodies remain to be a very

useful tool in discriminating RA from non-RA, HCV-infected patients

with neither RF nor cryoglobulinemia may have anti-CCP antibodies.

Because of limited patient numbers, this tentative conclusion may need

further confirmation with inclusion of more patient population.

PMID: 17876647

http://www.ncbi.nlm.nih.gov/pubmed/17876647

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