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Rheumatic manifestations and immunological abnormalities in patients with chronic hepatitis C. A study in the Middle
A al-Awadhi1, K al-Jarallah, F Hasan
1Department of Medicine, School of Medicine, Kuwait University, Kuwait.
Insights
Hepatitis C virus infection is linked to rheumatic conditions like joint pain and skin vasculitis. Screening for Hepatitis C is recommended for Middle Eastern patients with rheumatic or autoimmune diseases.
Area of Science:
- Hepatology
- Rheumatology
- Immunology
Background:
- Hepatitis C virus (HCV) infection and rheumatic disorders are prevalent in the Middle East.
- Shared clinical and immunological features between HCV and rheumatic diseases pose diagnostic challenges.
Purpose of the Study:
- To compare the prevalence of extrahepatic manifestations and immunological disorders in patients with chronic hepatitis C versus healthy controls.
- To investigate the association between Hepatitis C virus infection and rheumatic conditions in a Middle Eastern population.
Main Methods:
- A comparative study involving 40 patients with chronic hepatitis C and 42 matched healthy controls.
- Assessment of extrahepatic clinical manifestations, including rheumatic symptoms and immunological markers.
Main Results:
- Polyarthralgia or polyarthritis (35%) and cutaneous vasculitis (15%) were the most common rheumatic manifestations in HCV patients.
- Significantly higher prevalences of polyarthralgia, cutaneous vasculitis, rheumatoid factor, cryoglobulinemia, and anti-tissue antibodies were observed in the hepatitis C group compared to controls.
- Glomerulonephritis and xerophthalmia were infrequent, and systemic vasculitis was absent in the studied HCV patients.
Conclusions:
- Hepatitis C virus infection is associated with an increased prevalence of specific rheumatic manifestations and immunological abnormalities.
- The findings suggest a need for screening for Hepatitis C virus in Middle Eastern patients presenting with rheumatic or autoimmune disease features.
Abstract:
Hepatitis C virus infection and rheumatic disorders are both common in the Middle East and share many clinical and immunological manifestations, raising diagnostic problems. We compared the prevalence of extrahepatic clinical manifestations and immunological disorders in 40 patients with chronic hepatitis C and in 42 carefully matched healthy controls. Polyarthralgia or polyarthritis was the most common rheumatic manifestation (35%) in the cases, followed by cutaneous vasculitis (15%). Glomerulonephritis and xerophthalmia were uncommon, and none of the cases had systemic vasculitis. Immunological abnormalities included serum rheumatoid factor (47.5%), cryoglobulins (30%), and one or more antitissue antibodies (37.5%). The prevalences of polyarthralgia, cutaneous vasculitis, rheumatoid factor, cryoglobulinemia, and anti-tissue antibodies were significantly higher in the hepatitis C group than in the control group. Our data suggest that patients in the Middle East who present with features of rheumatic or autoimmune diseases should be screened for hepatitis C.