Detection of Viral DNA in Patients with Early Arthritis

OBJECTIVE: Viruses have a role in the pathogenesis (the origin and course of a disease) of various forms of arthritis. This study aimed at determining whether viral DNA can be detected in joint samples in the early stages of idiopathic (spontaneously arising) arthritides (plural of arthritis).

METHODS: Synovial fluid (SF) (a thick liquid that lubricates joints) and synovial tissue (ST) samples were obtained from 73 patients, with undifferentiated arthritis (n=22), rheumatoid arthritis (n=13), spondyloarthropathy (n=17), crystal arthropathy (disease in a joint) (n=8), osteoarthritis (n=7), septic arthritis (n=5), and trauma (n=1). The presence of viral DNA was investigated by polymerase (any of numerous enzymes that bring about DNA formation) chain reaction analysis.

RESULTS: Cytomegalovirus (a herpesvirus that incites cell enlargement) was present in 25 patients, parvovirus (any of a group of DNA viruses that are suspected of causing hepatitis) B19 in 15 patients, Epstein-Barr virus (a herpesvirus that is associated with certain types of cancer) in 12 patients, and herpes simplex virus in 16 patients (in ST, SF, or both), respectively. The joint samples were negative for viral DNA from adenovirus (any of a group of DNA viruses that cause respiratory disease) and varicella-zoster (a herpesvirus that causes chicken pox) virus. In ST, eight patients were double positive for parvovirus B19 and another viral DNA, with herpes simplex virus being the most prevalent. Seven patients were double positive for other viruses (cytomegalovirus, herpes simplex virus, Epstein-Barr virus). In SF, four patients were double or triple positive for viral DNA. Paired samples were available in 56 patients. In these, viral DNA was detected in 37 patients in ST, as compared with 19 in SF.

CONCLUSION: These data show that one or more viruses can be detected in the synovial specimens of patients with early arthritis, irrespective of the clinical diagnosis. This observation might be explained by migration of inflammatory cells harbouring viral DNA into the inflamed joints.

Source: Ann Rheum Dis 2000 May;59(5):342-346

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