Chronic Arthritis Is Not Related to HCV Viral Load

Autoimmune disorders, including chronic arthritis, are associated with hepatitis C virus (HCV) infection, but it is unclear whether this is due to the effects of the virus itself.

As reported in the June 21, 2006 online edition of Hepatology Research, Italian researchers assessed the prevalence of arthritis in chronic hepatitis C patients, looking at possible correlations with HCV replication, liver damage, and several serum markers of autoimmunity, including anti-keratin antibodies (AKA), cyclic citrullinated peptide (CCP) antibodies, rheumatoid factor (RF), anti-nuclear antibodies (ANA), and cryoglobulins.

Results

Out of a cohort of 380 patients, the authors identified 38 (10%) with arthritis; 10 of these were excluded because their arthritis developed before they were infected with HCV.

Data from patients with measurable AKA and CCP were not included in the statistical analysis because of the clear correlation between these parameters and rheumatoid arthritis.

Among the remaining 20 patients:

- 74% showed evidence of HCV viral replication;
- 47% showed evidence of liver damage;
- 42% had RF in their serum;
- 42% had evidence of cryoglobulins;
- 16% had detectable ANA.

There was no observed correlation between ANA serum concentrations and HCV replication.

A significant negative correlation between RF positivity and HCV replication was observed only in a subgroup of patients with serological evidence of hepatic damage (e.g., elevated ALT).

Conclusion

The authors concluded that these data support the hypothesis that the onset of arthritis and the presence of the autoimmunity markers ANA and RF are not related to HCV viral replication, but that other immunological mechanisms induced by HCV infection may play a role.

7/25/06

Reference
G Tarantino, A Riccio, A Spano, and others. HCV infection and chronic arthritis: Does viral replication matter? Hepatology Research. June 21, 2006 [Epub ahead of print].