MUSCULOSKELETAL MANIFESTATIONS AND AUTOANTIBODY PROFILE IN 90 HEPATITIS-C VIRUS-INFECTED ISRAELI PATIENTS

Objectives: Recent interest has been expressed in rheumatic manifestat ions in hepatitis C virus (HCV)-infected populations, The aim of this study was to determine the prevalence and characteristics of the muscu loskeletal manifestations and serological markers of autoimmunity in H CV-infected patients in Israel. Methods: Ninety anti-HCV-positive pati ents were consecutively interviewed and examined. The prevalence of au toantibodies and their association with rheumatologic symptoms were al so determined. Results: Rheumatic manifestations were found in 28 subj ects (31%), and included arthralgias (9%), arthritis (4%), cryoglobuli nemia (11%), sicca symptoms (8%), cutaneous vasculitis (2%), polymyosi tis (1%), and antiphospholipid syndrome (1%). Rheumatic complications were not associated with liver disease severity, or subjects' gender. In addition, myalgia was reported by 22 patients (24%), and fibromyalg ia was diagnosed in 14 (16%). Sixty-nine percent of the patients had a t least one autoantibody detected in their serum, the most prevalent b eing rheumatoid factor (RF), 44%; antinuclear antibody (ANA), 38%; and IgM and IgG anticardiolipin antibodies (acl), 28% and 22%, respective ly. The frequency of autoantibodies was not associated with liver dise ase severity or rheumatic disorders. Conclusions: Musculoskeletal mani festations and autoimmune markers are common in HCV infection. An inve stigation of risk factors for HCV infection is pertinent in a patient presenting new rheumatic manifestations and should be included in the history of present illness. Future studies of these disorders may unco ver the full spectrum of these associations and provide new insights i nto their operating mechanisms. Copyright (C) 1998 by W.B. Saunders Co mpany.