OBJECTIVE:

To report a case series of HCV-related arthropathy.

MATERIAL AND METHOD:

A retrospective study was done from January 2015 to December 2017 with patients with chronic HCV infection and arthropathy referred to our rheumatology clinic. All the patients were retrospectively reviewed. Risk factors for HCV infection including blood transfusion or intravenous drug abuse, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), anti-HCV (ELISA), viral genotype, and enzymes levels were examined. The clinical presentation of joint involvement, erosions, and type of treatment were also studied. Patients seropositive to HBV were excluded.

RESULTS:

There were included 31 patients. Risk factors were identified in only 28 cases, including blood transfusion (12) before 1992 and intravenous drug abuse (16). Rheumatoid arthritis coexisting with hepatitis C was found in 6 cases; all of these had anti-CCP, RF and erosions in 3. Nine patients gave a history of mild, symmetric poliar- thritis or oligoarthritis no-erosive resembling classic rheumatoid arthritis. Sixteen patients presented polyarthralgias. In total, RF was present in 77% out of 31 patients. Elevated enzymes were seen in 6 cases. Sulphasalazine, chloroquine, low dose prednisone and NSAIDs were commonly prescribed.

CONCLUSION:

The patients with HCV infection can present arthralgias/arthritis. The type of arthropathy must be differentiated due to the hepatotoxicity of disease modifying drugs. Anti-PCC antibody is useful for distinguishing HCV-related arthropathy from rheumatoid arthritis.

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