Anti-cyclic citrullinated peptide antibodies as a tool in diffrentiating patients with rheumatoid arthritis from patients with chronic hepatitis C infection-associated polyarticular involvement

To assess the utility of anti-cyclic citrullinated peptide [anti-CCP] antibodies in distinguishing between patients with rheumatoid arthritis [RA] and patients with polyarticular involvement associated with chronic hepatitis C virus [HCV] infection. All the patients enrolled in this study were examined in the outpatient department of medicine unit at Lady Reading Hospital Peshawar from February to December 2010. Serum anti-CCP antibodies and rheumatoid factor [RF] were evaluated in 29 patients with RA, 13 patients with chronic HCV infection a associated with articular involvement and 35 patients with chronic HCV infection without any joint involvement. Anti-CCP antibodies were detected in18 of 29 [62.1%] patients with RA, 7 of 13[53.8%] patients having HCV with RA like arthropathy but not in a single patient with chronic HCV infection with no articular involvement. Conversely, RF was detected in 25 of 29 [86.2%] patients with RA, 9 of 13 [69.2%] patients with HCV-related RA like arthropathy and 8 of 31 [22.9%] patients with HCV infection without joint involvement. This concludes that anti-CCP antibodies can be useful in discriminating patients with RA from patients with HCV-associated arthropathy