Arthritis and chronic hepatitis C virus infection
Abstract number: 1733_724
Puerto J., Escobar M.A., Garcia-Egido A.A., Fernandez F.J., Gomez-Soto F.M., Bernal J.A., Romero S.P., Gomez F.
Arthritis is one of the numerous manifestations of hepatitis C virus infection (HCV).
Objectives: To determine the prevalence of HCV in patients presenting with chronic peripheral inflammatory artritis (CPIA) and, the clinical forms of CPIAs associated with HCV in a 425 beds teaching hospital reference of the Bay of Cadiz (over 250.000 inhabitants).
Methods: Prospective case-control study in 1,972 patients presenting with CPIA as their predominant symptom (excluding cristal induced and degenerative arthritis), mean age (± SD) 47.6 ± 17.3 years, 64% of them women (n = 1,080). Control groups: 759 consecutive patients with non-inflammatory chronic arthritis (NICA), and 6,102 consecutive first time blood donors (BD) matched for age and sex. HCV status was determined (3rd generation ELISA confirmation by RT-PCR, and HCV genotype).
Results: The prevalence of HCV antibodies (5.6%) in patients with CPIA was higher than that in patients with NICA (2.6%) or BD (0.88%) (p < 0.01 in both cases). The prevalence of chronic HCV infection was higher in patients with CPIA (4.3%) than in BD (0.88%). The prevalence of chronic HCV infection by final diagnosis as compared to BD was: 3.1% for Rheumatoid arthritis (RA) (p < 0.01), 6.4% for seronegative RA (p < 0.005), 11.9% for intermitent mono-oligoarthritis (p < 0.001), 6.0% for Sjögren's syndrome (p < 0.005), and 9.8% for systemic lupus erythematosus (p < 0.001). The prevalence of chronic HCV infection in psoriasic arthritis, seronegative spondyloarthropathies, and other final diagnosis was not different than that in BD. CPIA associated to HCV infection was non erosive/non deforming in 76% of the patients. Type II cryoglobulins and, decreased levels of C4/C3 were detected in 37% and 48%/22% of the patients with CPIA associated to HCV infection, respectively.
Conclusions: An increased prevalence of HCV infection exists in patients presenting with chronic peripheral inflammatory arthritis. HCV antibodies (3rd generation ELISA) overestimates the prevalence of HCV infection in those patients. A search for HCV infection should be performed in the diagnostic process of both inflammatory arthritis and collagen vascular diseases.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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