Subject(s)
DNA Virus Infections/therapy , Herpesvirus 6, Human/isolation & purification , Lymphohistiocytosis, Hemophagocytic/virology , Mixed Connective Tissue Disease/virology , Adult , DNA Virus Infections/diagnosis , DNA Virus Infections/pathology , Diagnosis, Differential , Female , Humans , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/therapy , Mixed Connective Tissue Disease/complications , Mixed Connective Tissue Disease/diagnosis , Mixed Connective Tissue Disease/therapy , Treatment OutcomeABSTRACT
Many extrahepatic manifestations, including rheumatic diseases, have been reported to be associated with hepatitis C virus (HCV) infection. In order to investigate the prevalence of HCV infection among patients with rheumatic diseases, in the present study we interviewed 367 patients and tested their blood samples for HCV antibodies (anti-HCV) by an enzyme-linked immunosorbent assay. Anti-HCV-reactive samples were retested for confirmation by a line immunoassay and also for HCV RNA detection by the polymerase chain reaction. HCV RNA-positive samples were genotyped by INNO-LIPA. An overall HCV infection prevalence of 1.9% (7/367) was found. Of the 7 HCV-infected patients, 4 had systemic lupus erythematosus and 3 rheumatoid arthritis, resulting in positivity rates of 2.3 and 3.4%, respectively. HCV RNA genotyping revealed the presence of subtypes 1a (57.1%), 1b (28.6%) and 3a (14.3%). The clinical course was favorable for all HCV-infected patients, except one, who died due to renal insufficiency related to lupus nephritis. These results demonstrate a low HCV infection prevalence among the population studied. In the few positive cases, we observed no adverse influence of this infection on the clinical evolution of the rheumatic disease.
Subject(s)
Hepacivirus/genetics , Hepatitis C Antibodies/blood , Hepatitis C/epidemiology , Rheumatic Diseases/virology , Spondylarthropathies/virology , Adolescent , Adult , Aged , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Genotype , Hepatitis C/complications , Hepatitis C/diagnosis , Humans , Male , Middle Aged , Mixed Connective Tissue Disease/virology , Polymerase Chain Reaction , Prevalence , RNA, Viral/analysis , Rheumatic Diseases/complications , Seroepidemiologic Studies , Spondylarthropathies/complications , Vasculitis/complications , Vasculitis/virologyABSTRACT
We report on a carrier of human T-lymphotropic virus type 1 (HTLV-1) who developed mixed connective tissue disease (MCTD). This patient suddenly manifested clinical symptoms and interstitial pneumonia ascribable to MCTD following long-term infection with HTLV-1. After initiation of oral prednisolone all manifestations quickly improved in parallel with a decrease in inflammatory reactions. In this patient HTLV-1 infection might have played an important role in the pathogenesis of MCTD. Since HTLV-1 can cause adult T-cell leukemia and HTLV-1-associated myelopathy, and also collagen diseases including MCTD, careful observation is necessary even in a carrier, particularly when autoantibodies are detectable in serum.
