Objectives : To investigate the association or the relationship of rheumatic manifestations and cryoglobulins with hepatitis C infection in Egyptian patients and the effect of treatment by interferon on the outcome of the disease and associated rheumatic manifestations.
Methods : one hundred and twenty patients were recruited in this study, 20 of them were from internal medicine and hepatoloty clinics while the other hundred patients were from rheumatology Clinic. The prevalence and concentration of cryoglobulins by immunofixcation). rheumatoid factor (RF), antinuclear antibodies(ANA). various rheumatological manifestations, liver functions were investigated and hepatitis C virus was determined by ELISA & polymerase chain reaction, also liver biopsy was done for 4 patients.
Results : the prevalence of hepatitis C infections was 15% in the patients suffering from rheumatoid arthritis. 10% in patients suffering from systemic lupus Erythematosus (SLE). while it was varied between 14 to 23 % in the patients complaining of different rheumatic manifestations, the prevalence of cryoglobulins in hepatitis C patients complaining of different rheumatic manifestations, the prevalence of cryoglobulins in hepatitis C patients was 58%. while different rheumatic manifestations were varied bewteen 12.5% to 58% in hepatitis C patients. these rheumatic manifestations were improved -to some extent with treatemtn of HCV with interferon, also a significant correlation was found between most of rheumatic manifestations and the concentration of cryoglobulin.
Conclusion : Extra-hepatic clinical manifestations are frequently observed in HCV patients and involve primarily the joints. muscles and skin. The most frequent immunologic abnormalities include cryoglobulins. rheumatoid factor and antinuclear antibodies and HCv infection should be considered as one of the causes in patients with unexplained rheumatic symptoms.