RESUMEN
This study aimed at detecting the prevalence of HCV infection in systemic lupus erythematosus patients [SLE] and its clinical and immunological impact on these patients. 75 patients with SLE were randomly selected and 100 volunteers of blood donors were enrolled as a control group. After full careful clinical assessment, disease activity index [SLEDAI] was determined to all patients and all subjects were investigated by complete blood picture, liver enzymes and HCV antibodies by third generation ELISA. Subjects with positive antibodies were further investigated for viremia by HCV PCR. Immunological tests included C3, C4, ANA, Anti ds-DNA and cryoglobulin. Patients were divided into 2 groups according to presence or absence of HCV antibodies. Thirty two of SLE patients [43%] had positive HCV antibodies compared to 1 2[12%] of the control group while only 8 [11%] patients with SLE had detected viremia by PCR. Eighty eight percent of SLE patients with positive HCV antibodies had higher frequency of high disease activity index, 75% had elevated liver enzymes, 59% showed hypocomplementenemia and 63% had cryoglobulinemia. Cutaneous manifestations of SLE were found in 74% of SLE patients without HCV compared to 38% of those with HCV infection. SLE patients had higher prevalence of HCV infection than the general population. SLE HCV patients have less cutaneous manifestation, more frequent high disease activity index, hypocomlementenemia and cryoglobulinemia. Differentiating patients with HCV infection with clinical finding mimicking that of SLE [lupus like syndrome] from those with SLE associated with HCV infection is difficult. In this regard cutaneous manifestation could be a helpful sign. However, more specific serum markers for SLE are needed especially in our locality