Hepatitis C Virus-Related Arthtitis and Rheumatoid Arthritis: Could They Be Different Aspects of the Same Disease?

Abstract

The role played by HCV in the genesis of many autoimmune disorders has been reported in several studies. In particular, the onset of arthritis has been described in about 2-3 percent of HCV infection cases. At present, this HCV-related arthritis is classified as a reactive arthritis, but a real distinction of this form from classical rheumatoid arthritis is often difficult. In this presentation, the Authors distinguish two arthritic forms observed in HCV-related arthritis patients: one, characterized by asymmetrical oligoarticular-involvement, and another, with poly-articular symmetrical involvement. The Authors suggest that the latter can be considered as a form of rheumatoid arthritis, because of the similarity of the main clinical aspects and laboratory findings (rheumatoid factor, anti-cyclic citrullinated peptide antibodies) to those of classical rheumatoid arthritis, which make the two forms indistinguishable. Therefore, HCV could be considered the etiologic agent of a limited number of cases of rheumatoid arthritis.

The Significance of Articular Hand Manifestations in Chronic HCV Patients

“…It was found in this study that cryogloblins was present in 9.8% that is similar to some reports who found that cryoglobulinemia was present in 11% but less than others [9,24,35,36] . This may be ascribed to differences in ethnicity and geographic distribution.…”

HCV-Related Rheumatic Manifestations and Therapeutic Strategies

“…Usually, HCV--related polyarthritis shows a benign, often fluctuating clinical course (4,10,11,52). The majority of patients develop polyarticular disease, being the small joints (metacarpophalangeal, proximal interphalangeal, wrists and ankles) primarily involved; in some patients synovitis may also affect shoulders and knees, and large joint effusions have been described in 10--30% of cases as mono--/oligoarthritis (4,10,16,22,57). The presence of serum rheumatoid factor is quite common, in the absence of rheumatoid nodules, periarticular osteopenia or articular destruction, even if erosive findings can be observed in 1/3 of cases (4,10,16,22,57).…”

“…The majority of patients develop polyarticular disease, being the small joints (metacarpophalangeal, proximal interphalangeal, wrists and ankles) primarily involved; in some patients synovitis may also affect shoulders and knees, and large joint effusions have been described in 10--30% of cases as mono--/oligoarthritis (4,10,16,22,57). The presence of serum rheumatoid factor is quite common, in the absence of rheumatoid nodules, periarticular osteopenia or articular destruction, even if erosive findings can be observed in 1/3 of cases (4,10,16,22,57). The erythrocyte sedimentation rate is within normal limits in about half patients; more interestingly, serum anti--cyclic citrullinated peptide (anti--CCP) antibodies are invariably absent in HCV--related oligo--/polyarthritis with/without cryoglobulinemia (4, 10, 16, 22; Fig.…”

“…A peculiar subset of HCV patients with arthritis is represented by CV--associated arthritis. The latter usually is oligo--monoarticular, affecting the large joints of lower limbs, where the purpuric lesions are particularly frequent; furthermore, it is generally asymmetrical, intermittent, non--erosive, and characterized by better prognosis (4,10,16,22,57). Finally, given the relatively high prevalence of both HCV infection and RA in the general population it is not rare to observe a mere association between the virus and RA.…”

Manifestações musculoesqueléticas associadas à hepatite C crônica

“…O estudo de Buskila et al (1998) As infecções virais são consideradas um possível gatilho para doenças sistêmicas autoimunes (Riccio;Tarantino, 2012;Ramos-Casals et al, 2009). O mecanismo da manifestação extra-hepática no contexto da infecção pelo HCV não é claro (Buskila, 1998).…”