The case for hepatitis C arthritis.
OBJECTIVE
To present the data available supporting the existence of an arthropathy associated with hepatitis C infection.


METHODS
The MEDLINE database was searched for "arthritis" intersecting with "hepatitis C" in addition to the authors' investigations and experience on this subject.


RESULTS
Arthritis, not otherwise explained, has been noted in 2% to 20% of hepatitis C virus (HCV) patients. This arthritis is rheumatoid-like in two thirds of the cases and a waxing/waning oligoarthritis in the rest. Cryoglobulinemia alone does not explain the arthritis, and there is difficulty in differentiating it from rheumatoid arthritis. The arthropathy is nonerosive/nondeforming. Whereas nonsteroidal anti-inflammatory drugs, low-dose corticosteroids, and hydroxychloroquine may be helpful, conventional treatment of arthritis may be problematic in the context of viral hepatitic arthropathy. Antiviral therapy is most effective, even without viral clearance, but rheumatic complications may ensue.


CONCLUSIONS
HCV arthropathy should be considered in the differential diagnosis of new-onset arthritis.
Rosner
Itzhak
I
Department of Rheumatology, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel. rosneri@tx.technion.ac.il
Rozenbaum
Michael
M
Toubi
Elias
E
Kessel
Aharon
A
Naschitz
Jochanan E
JE
Zuckerman
Eli
E
D000465:Algorithms; D001168:Arthritis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology* / Q000628:therapy; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence