Rheumatoid Factor and Anti-Cyclic Citrullinated Peptide Antibodies Levels in Chronic Viral Hepatitis (B&C)

Background: Extrahepatic manifestations is a relatively common feature in patients with chronic hepatitis C virus infection. Among the different clinical disorders associated with HCV infection, articular involvement is a frequent complication, and the clinical picture of HCV related arthropathy varies widely. In particular, monoarticular or oligoarticular involvement affects larger joints and is typically associated with mixed cryoglobulinemia, whereas symmetric polyarthritis associated with HCV infection frequently displays a rheumatoid arthritis like clinical picture which can be clinically indistinguishable from RA itself. This study aimed to evaluate level of Rheumatoid Factor and anti-CCP level in chronic viral hepatitis B&C.

Patients and methods: Thirty patients with rheumatoid arthritis, thirty patients with chronic hepatitis C virus and thirty patients with chronic hepatitis B virus were selected to perform this study and they were compared to thirty normal subjects as a reference group.

Results: There was significant difference between the hemoglobin in the four groups. As regard Rheumatoid Factor there was significant difference between the studied groups. As regard Anti-CCP, there was significant difference between the studied groups. There was also significant difference between the four groups according to level of positivity. Finally, our study shows clinically significant positive correlation between RF as well as anti CCP titer and both HBV DNA and HCV RNA viral levels.

Conclusions: Rheumatoid factor was found with considerable percentage in chronic HBV & HCV patients without musculoskeletal manifestations. Anti-CCP can be detected with low positivity in chronic HBV&HCV patients even without arthritic manifestations. There is a significant positive correlation between RF titre and HBV DNA& HCV RNA in chronic hepatitis patients. There is a significant positive correlation between anti-CCP and HBV DNA& HCV RNA in chronic hepatitis patients. Chronic HBV & HCV can be considered and investigated in patients with positive RF and/or anti CCP without arthritic manifestations.