ABSTRACT
Hepatitis C virus [HCV] is frequently associated with rheumatic autoimmune manifestations including rheumatoid-like arthritis. This work is aimed to study the impact of concomitant HCV infection on rheumatoid arthritis [RA] patients. 110 RA patients [mean age 44.6 +/- 12.7, disease duration 7.92 +/- 6.56 years] were included. HCV infection was diagnosed by HCV-antibody [HCV-Ab] and polymerase chain reaction. Disease activity was assessed using the disease activity score 28 [DAS28] and radiological damage by a modified Larsen method. Functional disability was assessed by the Modified Health Assessment Questionnaire [MHAQ]. HCV-Ab was detected in 20% and viremia in 12.7% of RA patients. HCV-Ab positive patients were significantly older [p < 0.001] and had a longer disease duration [p = 0.02]. No differences were found between HCV-Ab positive and -negative patients in DAS28 and modified Larsen's scores, however, HCV-Ab positive patients had a higher frequency of deformities [p < 0.005] associated with older age [p < 0.001] and higher MHAQ scores [p = 0.002], independent of age and disease duration. They also had a higher frequency of hepatomegaly [p < 0.001] and vasculitis [p < 0.001]. Hepatomegaly was associated with older age [p = 0.004] and longer disease duration [p = 0.003] while vasculitis was associated with older age [p = 0.02]. Concomitant HCV infection in RA patients is associated with significant disability and comorbidities in the form of hepatomegaly and vasculitis. Hepatomegaly and vasculitis were associated with older age. Hepatomegaly was also associated with longer disease duration. Screening for HCV infection is recommended in Egyptian RA patients