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Rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies with hepatitis B and hepatitis C

Orhan Zengin1, Hamit Yıldız2, Zeynep Hanım Demir3

  • 1Faculty of Medicine, Gaziantep University, Turkey.

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University
|October 26, 2017
PubMed

Insights

Hepatitis B and C infections can show positive anti-cyclic citrullinated peptide (anti-CCP) levels, though anti-CCP remains a specific marker for rheumatoid arthritis (RA) diagnosis, particularly at high levels.

Area of Science:

  • Immunology
  • Hepatology
  • Rheumatology

Background:

  • Viral infections, including Hepatitis B (HBV) and Hepatitis C (HCV), are implicated in idiopathic rheumatological diseases.
  • Clinical presentations of HBV and HCV can mimic rheumatic diseases, complicating diagnosis.
  • Anti-cyclic citrullinated peptide (anti-CCP) is a key serological marker for rheumatoid arthritis (RA).

Purpose of the Study:

  • To investigate and compare anti-CCP and rheumatoid factor (RF) levels in patients with HBV and HCV infections.
  • To assess the diagnostic utility of anti-CCP in viral hepatitis patients presenting with rheumatic symptoms.

Main Methods:

  • Serum samples from 44 HBV patients, 43 HCV patients, 25 RA patients, and 46 healthy controls were analyzed.
  • Rheumatoid factor (RF) was quantified using nephelometry (IgM-RF detection).
  • Anti-CCP levels were measured via enzyme-linked immunosorbent assay (ELISA) using second-generation anti-CCP2 assays.

Main Results:

  • Anti-CCP positivity rates were 20.5% for HBV, 32.5% for HCV, 72.4% for RA, and 10.9% for controls.
  • While RF and anti-CCP positivity showed similar trends in HBV, HCV, and control groups, the RA group exhibited statistically significant differences (p < 0.01).

Conclusions:

  • Anti-CCP antibodies can be detected in patients with HBV and HCV infections.
  • Despite potential positivity in viral hepatitis, anti-CCP remains a highly sensitive and specific diagnostic marker for RA, especially when detected at high titers.
Abstract

Keywords:
anti-CCPhepatitisrheumatoid arthritis (RA)

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