Prevalence and correlates of hepatitis C virus–associated inflammatory arthritis in a population-based cohort

Ferucci, Elizabeth D.; Choromanski, Tammy L.; Varney, Danielle; Ryan, Holly S.; Townshend‐Bulson, Lisa; McMahon, Brian J.; Wener, Mark H.

doi:10.1016/j.semarthrit.2017.04.004

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…Hepatitis C virus‐related arthritis is a non‐erosive inflammatory arthritis associated with HCV infection with or without RF . In our cohort, 11% of patients had HCV‐related arthritis, which is similar to the prevalence of HCV‐associated arthritis described in previous studies, ranging from 2% to 20% . Although more than two‐thirds of patients with HCV‐related arthritis showed an improvement in TJC and SJC after DAA therapy, these data were limited to only to a small subset of patients whose joint counts were recorded post‐DAA therapy.…”

Section: Discussionsupporting

confidence: 83%

Impact of hepatitis C treatment on pain intensity, prescription opioid use and arthritis

et al. 2019

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Objective: To assess the impact of direct acting anti-viral (DAA) therapy for hepatitis C virus (HCV) infection on changes in pain intensity and prescription opioid use among Veterans. Methods:We conducted a retrospective cohort study of Veterans with HCV who were seen in a rheumatology clinic at least once while receiving DAA therapy between January 1, 2010 and December 31st 2016. Demographic characteristics, HCV status, HCV treatment characteristics, numeric rating scale (NRS) pain scores and opioid prescription data were extracted from the electronic medical record. Pain scores were averaged over 6 months prior to HCV treatment and 6 months after completion of treatment. Prescription opioid dose was converted to a morphine equivalent daily dose (MEDD) and averaged across the two 6-month intervals.Generalized estimating equations were used to model the change in average pain and MEDD from pre-to post-HCV treatment. Effect size was assessed using Cohen's d. Results:A total of 121 Veterans, 91% male with average age of 59 were included.Average pre-treatment pain was 4.4 (SD 2.4). The average reduction in pain scores was 0.6 points (P = 0.02, Cohen's d = 0.22) after treatment. Among 67 patients prescribed chronic opioid therapy at baseline, average pre-treatment MEDD was 52.4 mg (SD = 62.5 mg) and post-DAA treatment average MEDD was 49.5 mg (SD = 69.3 mg), representing a decrease by 2.9 mg (P < 0.01, Cohen's d = 0.14). Opioid dose reduction was seen in 43/67 patients and 12 patients discontinued opioids entirely.Conclusion: Among US Veterans, subjective pain scores had modest improvement and opioid prescriptions were mildly reduced following treatment with DAA.

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Section: Discussionsupporting

confidence: 83%

Impact of hepatitis C treatment on pain intensity, prescription opioid use and arthritis

et al. 2019

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“…The estimated prevalence of rheumatoid arthritis (RA) in Italy is 0.41% [4] and, although some evidences suggested a positive association with chronic HCV infection [5][6][7], data are conflicting and the relationship still uncertain [8][9][10]. Chronic stimulation of B lymphocytes by HCV can lead to the production of polyclonal IgG, cryoglobulins and rheumatoid factor, generating HCV-induced inflammatory arthritisis, which features overlaps with those of RA that can complicate the achievement of a differential diagnosis [11].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis

Sebastiani

Milazzo

Atzeni

et al. 2019

Modern Rheumatology

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Objectives. The recent itroduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revoluzionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown.Methods. Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidences and produce practical, hospitalwide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidences and the strength of their recommendations. Results.A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice. Conclusions.A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunsuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients. Significance and Innovations. HCV antibodies should be investigated at the time of diagnosis of RA and, in any case, before starting immunosuppressive therapy with disease modifying antirheumatic drugs (DMARDs). HCV eradication with DAA should be attempted as soon as possible, depending on patient conditions allowing a continuous oral treatment lasting 8-12 weeks  Conventional and biological DMARDs are allowed in patients with HCV infection, but they should be used cautiously in presence of advanced liver disease.

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“…Arthritis in HCV infection develops in 5%-10% of cases[ 79 ]: Symmetric polyarthritis in 2/3 of cases, and oligo- or monoarthritis in the rest 1/3 of cases. Morning stiffness for more than 1 h occurs in 70% of HCV infected patients with arthritis, whereas erosion in the joints and subcutaneous nodules are not observed.…”

Section: Hepatitis Cmentioning

confidence: 99%

Immune disorders and rheumatologic manifestations of viral hepatitis

Maslennikov¹,

Ивашкин²,

Efremova³

et al. 2021

WJG

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Infection with hepatotropic viruses is not limited to the liver and can lead to the development of various immunological disorders (the formation of cryoglobulins, rheumatoid factor, antinuclear antibodies, autoantibodies specific for autoimmune hepatitis and primary biliary cholangitis, and others), which can manifest as glomerulonephritis, arthritis, uveitis, vasculitis (cryoglobulinemic vasculitis, polyarteritis nodosa, Henoch-Schonlein purpura, isolated cutaneous necrotizing vasculitis), and other rheumatologic disorders, and be a trigger for the subsequent development of autoimmune hepatitis and primary biliary cholangitis. A further study of the association between autoimmune liver diseases and hepatotropic virus infection would be useful to assess the results of treatment of these associated diseases with antiviral drugs. The relationship of these immune disorders and their manifestations with hepatotropic viruses is best studied for chronic hepatitis B and C. Only isolated cases of these associations are described for hepatitis A. These links are least studied, and are often controversial for hepatitis E, possibly due to their relatively rare diagnoses. Patients with uveitis, glomerulonephritis, arthritis, vasculitis, autoimmune liver diseases should be tested for biomarkers of viral hepatitis, and if present, these patients should be treated with antiviral drugs.

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Prevalence and correlates of hepatitis C virus–associated inflammatory arthritis in a population-based cohort

Cited by 12 publications

References 25 publications

Impact of hepatitis C treatment on pain intensity, prescription opioid use and arthritis

Impact of hepatitis C treatment on pain intensity, prescription opioid use and arthritis

Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis

Immune disorders and rheumatologic manifestations of viral hepatitis

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