Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Hepatitis C Virus-Associated Polyarteritis Nodosa.

Saadoun,  David, Terrier,  Benjamin, Sene,  Damien, Maisonobe,  Thierry, Musset,  Lucile, Amoura,  Zahir, Resche Rigon,  Mathieu

Objective:

To analyse the main characteristics and outcome of polyarteritis nodosa (PAN)-type vasculitis associated with hepatitis C virus (HCV).

Methods:

We reported characteristics and outcome of 31 patients chronically infected with HCV who satisfied American College of Rheumatology and Chapel Hill criteria of PAN, seen between 1990 and 2009, in a university center.

Results:

Among a cohort of 161 patients with HCV-related vasculitis, 31 (19.2%) were diagnosed as having PAN. The median (Q1,Q3) age was 64.5 (49.5, 70.5) years with 54.8% of female. Compared with HCV-mixed cryoglobulinemia (MC) vasculitis, HCV-PAN displayed a more severe and acute clinical presentation with more frequent fever and weight loss (p<0.0001), severe hypertension (p=0.0006), gastrointestinal tract involvement (p<0.0001), severe acute sensory-motor multifocal mononeuropathy (p<0.0001), kidney and liver microaneurisms (p=0.0002) and increased C-reactive protein (p<0.0001). Complete clinical remission of vasculitis was achieved in 79.3% of HCV-PAN compared to 57.5% HCV-MC (p=0.050). In multivariate analysis, skin involvement (OR, 2.81; 95% CI 1.27 to 6.33), and PAN type vasculitis (OR, 3.01; 95% CI 1.16 to 8.96) were independently associated with a complete clinical response of HCV-vasculitis. A glomerular filtration rate lower than 70 ml/min (OR 0.54; 95% CI 0.24 to 1.21) was negatively associated with a complete clinical response of HCV-vasculitis. Clinical relapse rate was higher in HCV-PAN compared to HCV-MC (75% versus 12%, p=0.002, respectively under rituximab). Five-years survival rate was 86% in the whole cohort, regardless of the vasculitis type.

Conclusion:

HCV-PAN account for 19.2% of our cohort of HCV vasculitis. HCV-PAN dysplay a more severe and acute clinical presentation and higher rate of clinical remission.

To cite this abstract, please use the following information:
Saadoun, David, Terrier, Benjamin, Sene, Damien, Maisonobe, Thierry, Musset, Lucile, Amoura, Zahir, et al; Hepatitis C Virus-Associated Polyarteritis Nodosa. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2024
DOI: 10.1002/art.29789

Abstract Supplement

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