HEPATITIS-C VIRUS-ANTIBODY (ANTI-HCV) - PREVALENCE IN PSORIASIS

Background. In cases of psoriasis tps), the etiology of the underlying liver disease is occasionally unknown. To investigate antibodies to h epatitis C virus (anti-HCV), their prevalence and clinical significanc e, 118 unselected outpatients with ps were studied prospectively. Meth ods. Anti-HCV was assayed in serum by second-generation enzyme-linked immunosorbent assay (ELISA), considering a serum anti-HCV (+), when th e optical density ratio was equal to or greater than three times the c ut-off value, in duplicate determinations, whereas anti-HBc, anti-HBs, HBsAg, anti-HBe, and HBeAg were also evaluated by ELISA, as were the transaminases. As controls we took the 1.2% anti-HCV prevalence found in 60,000 blood donors from Buenos Aires city. Results. Nine of 118 se rum samples (7.6%) proved to be anti-HCV (+) (P < 0.001). There were n o differences between positive and negative cases as regards gender, a ge, history of hepatitis, transfusions, or parenteral exposure, diseas e duration, or psoriasis type, and prior treatment with methotrexate a nd etretinate. Fifteen percent (17/113) were anti-HBc (+), 64.7% anti- HBs (+) (11/17) and 2.5% HBsAg (+) (3/17), whereas 3/17 (2.5%) showed isolated anti-HBc positivity. Liver biopsies in six anti-Hcv patients disclosed four with chronic active hepatitis, one with cirrhosis, and one with steatosis. Conclusions. In the presence of liver disease in P S patients, an HCV infection should be considered as an alternative di agnosis. The high anti-Hcv prevalence in this series is attributable t o infection by inapparent parenteral routes, through minute skin abras ions, as reported for hepatitis B virus in PS.