Prevalence and impact of chronic hepatitis C virus infection on the clinical manifestations and disease activity among patients suffering from systemic lupus erythematosus

ABSTRACT

To study the prevalence of anti-HCV antibodies among patients suffering from systemic lupus erythematosus [SLE] as well as to determine the impact of chronic HCV infection on the clinical manifestations and disease activity. Ninety-eight consecutive SLE patients presented to the rheumatology department, Cairo University Hospitals were included in the study. All patients were screened for anti-HCV antibodies using a 3rd generation enzyme-linked immune-sorbent assay [ELISA]. Patients with positive anti-HCV were tested for the presence of HCV-RNA by polymerase chain reaction [PCR]. Patients were classified into two groups; HCV/SLE and non-HCV/SLE according to the presence or absence of anti-HCV antibodies. Twenty/98 patients [20.4%] were positive for HCV antibody. Eight/98 patients [8.2%] had active viremia. SLE patients with positive anti-HCV antibodies tend to be older in age and having a longer SLE duration than non-HCV/SLE Patients. HCV/SLE patients had significantly lower mucocutaneous manifestations [p < 0.05] and higher cardiac manifestations and fundus abnormalities [p < 0.04, p < 0.01 respectively] than non-HCV/SLE patients. There was no statistical difference between the Systemic Lupus Erythematosus Disease Activity Index [SLEDAI] score between both groups. Patients with HCV/SLE were less frequently on oral steroids than patients with non-HCV/SLE HCV antibodies and active HCV viremia were found in 20.4% and 8.2% respectively among SLE patients. SLE with positive anti-HCV antibodies tend to be older in age and having longer SLE disease duration, lower mucocutaneous and higher cardiac manifestations and fundus abnormalities. Concomitant chronic HCV infection has no adverse impact on SLEDAI