Prevalence and correlates of hepatitis C Virus-Associated inflammatory arthritis in a population-based cohort

• Published in: Seminars in arthritis and rheumatism 2017-12, Vol.47 (3), p.445-450
• Main Authors: Ferucci, Elizabeth D, Choromanski, Tammy L, Varney, Danielle T, Ryan, Holly S, Townshend-Bulson, Lisa J, McMahon, Brian J, Wener, Mark H
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Alaska - epidemiology; Analysis of Variance; Antibodies, Antinuclear - blood; Arthritis; Arthritis, Infectious - blood; Arthritis, Infectious - diagnosis; Arthritis, Infectious - epidemiology; Arthritis, Infectious - virology; Autoantibodies; Autoantibodies - blood; Chronic; Cross-Sectional Studies; Cytokines; Diagnosis, Differential; Female; Fibromyalgia; Hepacivirus - immunology; Hepatitis; Hepatitis C virus; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - epidemiology; Humans; Infectious; Longitudinal Studies; Male; Middle Aged; Rheumatology; Self Report
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2017.04.004

Abstract Objectives The objectives of this study were to determine the prevalence of hepatitis C virus-associated inflammatory arthritis; describe its clinical and immunologic correlates; and to identify features that are characteristic of arthritis in chronic hepatitis C. Methods Participants with chronic hepatitis C infection enrolled in a population-based cohort study in Alaska and who had not received anti-viral treatment for hepatitis C were recruited. In a cross-sectional study, we assessed joint symptoms and signs, performed autoantibody and cytokine testing, and abstracted medical records for features of hepatitis C and arthritis. Results Of the 117 enrolled participants, 8 (6.8%) had hepatitis C-associated arthritis. The participants with arthritis were younger than those without (median age 45 vs. 52, p=0.02). Rheumatoid factor was commonly present among patients with hepatitis C-associated arthritis. The only studied autoantibody found more commonly in patients with HCV arthritis than those without arthritis was antinuclear antibody (63% vs. 23%, p=0.026). The only joint symptom significantly more common in hepatitis C arthritis was self-reported joint swelling (75% vs. 26%, p=0.007). Features of fibromyalgia were more common and functional status was worse in those with arthritis than those without. No cytokines differed in patients with and without arthritis. There were no associations of arthritis or autoantibodies with liver-related outcomes. Conclusions In this study of a cohort of individuals with chronic HCV infection, HCV-associated arthritis was present in less than 10%. Few serologic features distinguished participants with or without arthritis, but self-reported joint swelling was more common in those with arthritis.