Musculoskeletal manifestations & autoantibody profile in 90 hepatitis C virus infected Israeli patients

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OBJECTIVES: Recent interest has been expressed in rheumatic
manifestations in hepatitis C virus (HCV)-infected
populations. The aim of this study was to determine the
prevalence and characteristics of the musculoskeletal
manifestations and serological markers of autoimmunity in
HCV-infected patients in Israel.

METHODS: Ninety anti- HCV-positive patients were consecutively
interviewed and examined. The prevalence of autoantibodies and
their association with rheumatologic symptoms were also determined.

RESULTS: Rheumatic manifestations were found in 28 subjects
(31%), and included arthralgias (9%), arthritis (4%),
cryoglobulinemia (11%), sicca symptoms (8%), cutaneous
vasculitis (2%), polymyositis (1%), and antiphospholipid
syndrome (1%). Rheumatic complications were not associated
with liver disease severity, or subjects' gender. In addition,
myalgia was reported by 22 patients (24%), and fibromyalgia
was diagnosed in 14 (16%). Sixty-nine percent of the patients
had at least one autoantibody detected in their serum, the
most prevalent being rheumatoid factor (RF), 44%; antinuclear
antibody (ANA), 38%; and IgM and IgG anticardiolipin
antibodies (ac1), 28% and 22%, respectively. The frequency of
autoantibodies was not associated with liver disease severity
or rheumatic disorders.

CONCLUSIONS: Musculoskeletal manifestations and autoimmune
markers are common in HCV infection. An investigation of risk factors
for HCV infection is pertinent in a patient presenting new rheumatic
manifestations and should be included in the history of
present illness. Future studies of these disorders may uncover
the full spectrum of these associations and provide new
insights into their operating mechanisms.

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