ABSTRACT
Among the different clinical disorders associated with hepatitis C virus [HCV] infection, articular involvement is a frequent complication. Symmetric polyarthritis associated with HCV infection frequently displays a rheumatoid arthritis [RA] like clinical picture. Thus, differentiating patients with HCV related symmetric polyarthritis from patients with RA represents both a diagnostic and a therapeutic challenge. Our aim was to investigate whether antikeratin antibodies [AKAs] could be useful markers in differentiating patients with rheumatoid arthritis [RA]; from patients with hepatitis C virus [HCV,] associated polyarthritis who are seropositive for rheumatoid factor [RF]. Serum AKAs were determined in two groups of patients; all were RF seropositive. Group [I]: 25 patients with HCV associated symmetric polyarthralgia or arthritis: Group [II]: 25 patients with RA [ACR revised criteria for diagnosis of RA, 1988]. Fifteen healthy individuals, age and sex matched, served as controls. AKAs were tested using an indirect immunofluorescence technique with 1:10 serum dilution. The study revealed that AKAs were detected in 15/25 [60%] patients with true RA and in only 3/25 [12%] patients with HCV associated arthritis [p<0.0001]. AKAs were not found in the sera of the healthy controls. AKAs can be useful markers in differentiating patients with true RA from those with HCV arthritis