Rheumatic manifestations of hepatitis C infection

Siegel, Lori; Cohn, Lester; Nashel, David J.

doi:10.1016/s0049-0172(05)80035-6

Cited by 41 publications

(14 citation statements)

References 24 publications

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“…HCV infection leads to chronic hepatitis in up to 75-85% of patients, with 20-25% developing cirrhosis [2][3][4]. Additionally, HCV infection is also associated with a variety of nonhepatic manifestations including vasculitis, arthritis, thyroid disease, and fatigue [5][6][7][8][9][10]. Both hepatic and the nonhepatic manifestations of HCV have a profound negative impact on patient's health-related quality of life (HRQL) [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection

et al. 2007

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In addition to chronic hepatitis, many individuals infected with hepatitis C virus (HCV) suffer from fatigue, which may compromise their health-related quality of life (HRQL). To assess systematically health-related quality of life (HRQL) in patients with chronic hepatitis C and to determine if any clinical, biochemical, virologic, demographic, and histologic features are associated with HRQL status. In this cross-sectional observational study, one hundred thirty patients with chronic HCV infection (HCV RNA positive by PCR) and 61 healthy controls were enrolled from a tertiary care teaching medical center. All patients and controls completed one generic HRQL questionnaire (MOS SF-36) and one liver-disease specific instrument (Chronic Liver Disease Questionnaire, CLDQ). Ninety-five HCV patients and all the controls also completed a fatigue questionnaire (Chronic Fatigue Screener, CFS) and had immunologic markers determined (Cryoglobulin, Soluble IL-2 receptors, Rheumatoid Factor). We compared the HRQL of HCV-infected patients to the controls and, using data from other studies, to the general population, patients with diabetes, and patients with chronic low back pain. Patients with chronic HCV had greater HRQL impairment than healthy controls and those with type II diabetes. Fatigue was the most important symptom with negative impact on HRQL. Sixty-one percent of HCV-infected patients reported fatigue-related loss of activity. Additionally, other factors associated with HRQL were gender and histologic cirrhosis. Chronic HCV infection has a profound negative impact on patients' HRQL. Disabling fatigue is the most important factor that contributes to loss of well-being in this relatively young group of patients.

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Section: Introductionmentioning

confidence: 99%

“…From all these factors, RF is detected in 70-76% and cryoglobulins 40-45% of infected individuals, respectively [5][6][7][8][9]. In addition to these autoimmune markers, soluble interleukin-2 receptors (SIL-2R), another marker of immune activation, may also correlate with disease activity [10].…”

Section: Introductionmentioning

confidence: 99%

Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection

et al. 2007

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“…In cases of community-acquired infection, 62% develop chronic hepatitis in the USA [5]. Recent data show evidence for the presence of several autoimmune phenomena in patients with HCV infection, such as oligo-or polyarthritis [6,7], primary Sjogren's syndrome [8,9], membranoprolifcrative glomerulonephritis [10], cryoglobulinaemia [11][12][13][14], antinuclear, anti-mitochondrial, and anti-smooth muscle antibodies [11], rheumatoid factors [11,13], autoantibodies targeting a host protein named GOR, cloned from a chimpanzee infected with non-A, non-B hepatitis [15,16], and LKM-1 antibodies in adult palients with concomitant type 2 autoimmune hepatitis [17][18][19][20][21]. Some of the events were related to interferon-alpha {lFN-«) treatment [22] or to concomitant HCV infection due to exposure to human blood products [23].…”

Section: Introductionmentioning

confidence: 99%

Non-muscle myosin as target antigen for human autoantibodies in patients with hepatitis C virus-associated chronic liver diseases

Mühlen

Chan

Peebles

et al. 1995

Clinical and Experimental Immunology

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SUMMARYThree patients with hepatitis C virus (HCV)-related chronic liver disease were shown to have autoantibodies strongly reacting with cytoskeletal fibres of non-muscle cells. The heavy chain of non-muscle myosin microfilament was the main target for those autoantibodies. as determined by (i) cell and tissue immunofluorescence studies showing colocalization with an anti-myosin antibody prototype; (ii) primary reactivity in immunoblotting with a 200-kD protein, using either MOLT-4 cells, human platelets, or affinity-purified non-muscle myosin as antigen extract; and (iii) immunoblotting of similar Immunoreactive fragments in papain-digested MOLT-4 cell extracts, by using those human sera and antibody prototype. Autoantibodies to non-muscle myosin heavy chain were not previously reported in patients with chronic liver diseases, especially in those associated with HCV infection.

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“…This latter biological characteristic has been demonstrated in chronically infected individuals with and without hepatitis, as well as in mixed cryoglobulinaemia MC patients. HCV appears to trigger autoimmune responses that might become evident in the form of autoantibodies, cryoglobulins, circulating immunocomplexes, rheumatoid factor, and clinically evident extrahepatic manifestations [Siegal et al, 1993;Clifford et al, 1995;Ferri and Zignego, 2000]. Autoantibodies such as RF, which may play a role in cryoglobulinaemia, or ANA are found in association with chronic HCV infection, albeit at quite in low titres as a rule.…”

Section: Discussionmentioning

confidence: 99%

Mixed cryoglobulinaemia and chronic hepatitis C virus infection: The rheumatic manifestations

Leone

Pellicano

Maiocco

et al. 2001

Journal of Medical Virology

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The prevalence of rheumatologic symptoms in patients with mixed cryoglobulinaemia associated to chronic hepatitis C virus (HCV) infection was investigated. One hundred fourteen patients (96 female, mean age 63.5 years) with chronic HCV infection and cryoglobulinaemia were recruited. The presence, concentration, and type of cryoglobulins were tested by immunofixation. Rheumatoid factor (RF) and antinuclear antibody (ANA) were also measured. Rheumatological related symptoms were investigated by anamnesis and clinical evaluation. HCV genotype was determined by polymerase chain reaction (PCR) with genotype specific primer. Type II cryoglobulinaemia was identified in 39 cases and it was of type III in 58. HCV-RNA genotype was determined in 62 patients: 47 (76%) were infected by genotype1b, 8 (13%) by genotype 2a, while other genotypes were less common. RF and ANA were, respectively, present in 36 (31.5 %) and 4 (3.5 %) patients at low titre (RF < 50 UI/ml, ANA < 1:80). Of the 114 patients, 51 (44.7%) complained for rheumatological symptoms. The mean cryocrit value in these patients was 2,6 %, while in patients with HCV infection, liver disease, and cryoglobulinaemia without rheumatological symptoms the cryocrit value was lower than 0.5% in 50% of cases. It is concluded that patients with chronic HCV infection reported a wide variety of rheumatological manifestations, impairing their quality of life, with discrete frequency. These results suggest that HCV infection should be considered in the differential diagnosis of rheumatological symptoms of unknown origin.

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Rheumatic manifestations of hepatitis C infection

Cited by 41 publications

References 24 publications

Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection

Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection

Non-muscle myosin as target antigen for human autoantibodies in patients with hepatitis C virus-associated chronic liver diseases

Mixed cryoglobulinaemia and chronic hepatitis C virus infection: The rheumatic manifestations

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