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Rheumatology Advance Access published online on April 26, 2005
Rheumatology, doi:10.1093/rheumatology/keh668
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received October 25, 2004
Accepted March 29, 2005

Original Papers

Rheumatological manifestations of hepatitis C: incidence in a rheumatology and non-rheumatology setting and the effect of methotrexate and interferon

M. J. Nissen 1, E. Fontanges 1, Y. Allam 1, F. Zoulim 2, C. Trépo 2, and P. Miossec 1*

1 Departments of Immunology and Rheumatology, Hôpital Edouard Herriot, Lyon, France
2 Department of Hepatology, Hôtel Dieu, Lyon, France

* To whom correspondence should be addressed.
P. Miossec, E-mail: miossec{at}univ-lyon1.fr


  Abstract

Objectives. To evaluate hepatitis C virus (HCV)-positive patients followed in a rheumatology department and to compare them with a similar population of HCV-positive patients who had never seen a rheumatologist, in order to describe the rheumatological symptoms present and the effects of methotrexate and interferon-alpha therapy.

Methods. We performed a retrospective study of clinical, radiological and biological data on 21 rheumatology patients (Group I) presenting symptoms consistent with a chronic inflammatory arthritis with a known HCV infection and compared them with 41 members of an HCV support association (Group II).

Results. Symptoms of myalgia, sicca syndrome, Raynaud's phenomenon or paraesthesias were similarly frequent in the two groups. However, inflammatory joint pain and joint swelling were more common in Group I. In this group rheumatoid factor was positive in 48%, antinuclear antibodies in 26%, cryoglobulin in 44% and a reduced complement level in 63%. The majority of patients from Group I treated with methotrexate demonstrated an amelioration of the rheumatological symptoms with few negative outcomes. Regarding interferon-alpha therapy and rheumatological symptoms--in Groups I and II respectively 50 and 66% demonstrated a deterioration, 33 and 30% showed no change and 17 and 4% showed an amelioration.

Conclusion. Rheumatological symptoms are common in patients chronically infected with HCV. It is essential to individualize the role of treatment with interferon-alpha and to consider the use of methotrexate for difficult cases.

Keywords: Arthritis; Hepatitis C; Methotrexate; Interferon.
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