Anti-cyclic citrullinated peptide antibodies as a discriminating marker between rheumatoid arthritis and chronic hepatitis C-related polyarthropathy

ABSTRACT

Articular involvement is a frequent extrahepatic manifestation of hepatitis C virus infection. The distinction between HCV-related polyarthropathy and true RA may be very difficult especially with recent onset RA before articular damage and erosions develop. To assess the diagnostic utility of anti-CCP antibodies and compare it with that of rheumatoid factor in distinguishing between rheumatoid arthritis and HCV related polyarthropathy. Anti-CCP antibodies and RF were determined in the sera of 30 patients with RA and 22 patients with HCV-related polyarthropathy. Anti-CCP antibodies were positive in 83.3% of patients with RA and in 4.5% in patients with HCV and polyarthropathy. RF was positive in 90% of RA patients and in 81.1% of HCV patients with polyarthropathy. The anti-CCP antibodies showed higher specificity for RA compared to RF [95.4% Vs 18.2%]. However the sensitivity of anti-CCP was comparable to that of RF [83.3% Vs 90%]. Anti-CCP antibodies are reliable laboratory markers to differentiate between RA and HCV-related polyarthropathy