Prevalence of HCV infection among Patients with Inflammatory Polyarthritis Resistant to Conventional Therapy

Introduction HCV-related arthritis can present with clinical manifestations simulating rheumatoid arthritis (RA). Thus, it may be difficult to distinguish HCV related arthritis from RA. RF is positive in 80% of patients with RA, but in HCV-related arthritis, this positivity is between 54% and 82%. Objective Recognition of HCV infection among patients with inflammatory RF positive polyarthritis poorly responding to conventional treatment. Methods 150 patients were screened for HCV and anti CCP antibodies. Cases with positive serology for HCV were further evaluated by Real time Quantitative PCR. Results 129 patients were positive for HCV (86%). 117 patients (78%) showed HCV and RF positivity with negative Anti CCP. 12 patients were positive only for RF (8%), 9 patients were positive for Anti CCP and RF but negative for HCV( 6%), 12 patients were positive for all (8%). Conclusion Patients with atypical inflammatory polyarthropathy who are exposed to DMARDs according to symptomatic affection, RF positivity and radiological prove of arthritic activity, should gain our attention for the possibility of associated HCV especially when presented with elevated liver enzymes or unsatisfactory response to treatment.