[Hepatitis C virus infection and arthritis. A clinico-serological investigation of arthritis in patients with or without cryoglobulinemic syndrome].

Abstract

OBJECTIVE:

To compare the clinico-serological features of arthritis from two HCV+ patient groups characterized by mixed cryoglobulinemia (MC) or chronic hepatitis (CH).

METHODS:

We retrospectively studied 157 MC patients (119 females, mean age 64.8 yrs, range 36-88) and 155 CH patients (103 females, mean age 58.8 yrs, range 30-81). Patients with HBV and/or HIV co-infections and a follow-up shorter than 1 year were excluded. MC was classified according to standard criteria, while CH classification was based on Desmet's criteria.

RESULTS:

No differences in epidemiology were demonstrated between the two series of patients. Although significantly prevalent in MC patients, extra-hepatic manifestations including nephropathy, neuropathy, pneumopathy, mixed cryoglobulins, RF positivity and hypocomplementemia were detected in both patient groups. Arthritis was present in 23 CH (15%) and 12 MC (8%) patients. A symmetrical polyarthritis was observed in 87% of 23 CH patients, while cryoglobulinemic arthritis was invariably asymmetrical and pauciarticular. Unlike MC patients, who had a constantly non-erosive arthritis, in 7/23 CH patients arthritis was erosive. Steroids and/or hydroxycloroquine or D-penicillamine were safe and useful in controlling the arthritis over the short-medium time, although clinical response was more evident in MC patients. Instead, in 5/23 CH and 3/12 MC patients, interferon-alpha treatment was able to trigger or exacerbate the arthritis despite a good control of liver function.

CONCLUSIONS:

HCV infection seems to be, possibly in genetically predisposed patients, responsible for arthritis at times similar to rheumatoid arthritis. In these patients a careful assessment of the interferon-alpha treatment is mandatory owing to the potential "arthritogenic effect" due to its immunoregulatory properties.

• Authors: P Fadda, L La Civita, A L Zignego, C Ferri
• Journal: Reumatismo (Reumatismo) 2002 Oct-Dec Vol. 54 Issue 4 Pg. 316-23 ISSN: 0048-7449 [Print] Italy
• Vernacular Title: Epatite C e artrite. Studio clinico-sierologico dell'artrite in pazienti con e senza sindrome crioglobulinemica.
• PMID: 12563365 (Publication Type: English Abstract, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthritis, Infectious (blood, complications, diagnosis, virology)
• Cryoglobulinemia (complications)
• Female
• Hepatitis C (blood, complications, diagnosis)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Serologic Tests
• Syndrome