Rheumatoid arthritis (RA) is an inflammatory joint disease, with an overall prevalence of 0.46% worldwide. 1 The disease is characterized by bone erosion, loss of articular cartilage, chronic synovial inflammation, causing joint pain, swelling, stiffness, and disability in performing physical functions. 2,3 Although all joints are subject to the disease, RA usually affects the joints of the feet, knees, and hands. 4 The clinical manifestations of RA are usually not limited to joints but can turn into a systemic disorder involving the blood vessels, kidneys, lungs, heart, and liver. Furthermore, RA patients may suffer from nonspecific complications such as weight loss, fatigue, and malaise. 5 The presence of either rheumatoid factor (RF) or anti-citrullinated peptide antibodies (ACPAs) has usually been used as the hallmark of RA. 6 This disease is multifactorial lying on genetic as well as environmental factors triggering its pathogenesis. 7 Environmental factors such as obesity and diet, smoking, infections, and microbiota have been recognized as risk factors to develop RA in the predisposed population. 8 HLA and some non-HLA genes were also associated with susceptibility to RA. It was established that HLA alleles HLA-DRB1*01, HLA-DRB1*04, HLA-DRB1*13, and DRB1*15 are linked to RA susceptibility. 9Infections have long been known as a main player in the pathogenesis of RA. Some of the pathogens can involve multiple routes