Rheumatoid-like Arthritis Associated with Hepatitis C

Area of Science:

• Rheumatology
• Hepatology
• Infectious Diseases

Background:

• Rheumatoid arthritis (RA) etiology is largely unknown, with infectious causes hypothesized.
• RA is characterized by chronic joint inflammation, morning stiffness, and symmetric polyarthritis.
• Some RA-like conditions may have non-infectious origins or mimic infectious diseases.

Purpose of the Study:

• To investigate a potential association between hepatitis C virus (HCV) infection and a rheumatoid arthritis-like disease.
• To describe the clinical, laboratory, and histopathological findings in patients with this condition.
• To evaluate the response to alpha-interferon therapy in affected patients.

Main Methods:

• Case series describing three female patients with chronic, nonerosive arthritis.
• Laboratory investigations included liver enzymes, acute phase reactants, rheumatoid factor, cryoglobulins, and HCV serology.
• Liver biopsies were performed to assess hepatic pathology.
• Treatment with alpha-interferon was administered to some patients.

Main Results:

• Patients presented with prolonged morning stiffness and symmetric polyarthritis.
• Laboratory results showed minimal liver enzyme elevation, systemic inflammation, positive rheumatoid factor, and cryoglobulins.
• HCV serology was positive, and liver biopsies indicated hepatitis and early cirrhosis.
• Two of three patients experienced clinical improvement in arthritis following alpha-interferon therapy.

Conclusions:

• Hepatitis C virus infection is a potential cause of rheumatoid-like arthritis.
• HCV-associated arthritis may be chronic, nonerosive, and unresponsive to NSAIDs.
• Alpha-interferon therapy may offer a therapeutic option for HCV-related arthritis.