Musculoskeletal Complaints and Serum Autoantibodies Associated with Chronic Hepatitis C and Nonalcoholic Fatty Liver Disease

Abstract

We sought to compare the musculoskeletal symptoms and immune markers found in chronic hepatitis C (HCV) and nonalcoholic fatty liver disease (NAFLD). Patients with HCV or NAFLD answered a questionnaire and donated serum for autoantibody testing. Univariate analysis between the HCV and NAFLD groups revealed joint pain in 67% of the HCV group and 65% of the NAFLD group. Those with joint pain reported inflammatory characteristics that were similar between the groups. The presence of a positive rheumatoid factor and cryoglobulins was higher in the HCV group, however both groups had a similar prevalence of a low positive antinuclear antibody (ANA). We conclude that the NAFLD group reported a higher amount of joint pain and inflammatory joint symptoms than anticipated. We were unable to determine a variable that predicted the presence of joint pain. Therefore, more investigation is needed to determine whether these findings are due to liver disease alone.

Prevalence and risk factors for patient-reported joint pain among patients with HIV/Hepatitis C coinfection, Hepatitis C monoinfection, and HIV monoinfection

“…Our study extends results of prior cross-sectional analyses, which have reported that 67-81% of chronic HCV-infected patients complain of musculoskeletal pain [ 23 , 24 ]. Tsui et al [ 25 ] found that HIV/HCV coinfection was more commonly associated with musculoskeletal pain compared to HIV-monoinfection (aOR, 1.45; 95% CI, 1.06-1.97), and adjusting for inflammatory cytokine levels and depression did not change these results.…”

Predictive Clinical Value of Rheumatoid Factor and Anti-Citrullinated Protein Antibodies as Diagnostic Tools in Cases with Non-Arthritic Chronic Hepatitis C Viral Disease

“…Additionally, previous research teams revealed and displayed that the calculated statistical prevalence of high-positive anti-citrullinated protein antibody levels was correspondingly low at 1.1%. As a result, anti-citrullinated protein antibody could ensure enhanced clinical significance in implementation in clinical diagnosis of rheumatoid arthritis in the current and previously similar research studies [2,6] In great harmony with the current research study results a prior research has shown that female study subjects revealed a greater prevalence of positive rheumatoid factor. This could be justified in correlation to gender-sex hormonal serum levels that could trigger autoantibodies production [3,7].…”

“…Cases having chronic hepatitis C infection may develop rheumatic clinical presenting profile e.g., arthralgia, arthritis, vasculitis and around 19%-80% of nonarthritic hepatitis C virus chronic infected cases could have raised rheumatoid factor, the elevated prevalence of rheumatoid factor in cases with chronic HCV infection considerably eliminates the diagnostic value of rheumatoid factor for rheumatoid arthritis in this group of cases. Anti-citrullinated protein antibody levels should be implemented in the rheumatoid arthritis cases diagnosis approach with coexisting hepatitis C virus infection, because anti-citrullinated protein antibody levels is rarely present in HCV infected cases without arthritis [5,6] research criteria were age older than 18 years, written informed consent was obtained from all study subjects Hospital approved protocol and positivity for both anti-HCV antibody and HCV RNA was obtained. Exclusive research criteria involved known inflammatory arthritis; hepatitis B surface elevated antigen levels, past usage of antiviral therapy.…”

Predictors of pain intensity and pain functioning in patients with the hepatitis C virus

“…This finding is consistent with a recent study that analyzed the association between the severity of histological liver inflammation and the presence of joint pain in HCV patients. The authors did not identify disease or medication-related variables that predicted joint pain in HCV patients [41]. …”