title: Treatment strategies for a patient with rheumatoid arthritis and hepatitis C.
abstract: BACKGROUND
  The poor prognosis of rheumatoid arthritis (RA) can be aggravated by the concomitant presence of chronic hepatitis C virus (HCV) infection and there are no guidelines for the treatment of patients affected by both conditions.
  
  
  OBJECTIVE
  To propose new therapeutic strategies for patient affected by RA and concomitant HCV chronic infection.
  
  
  METHODS
  Review of the literature on the usage of cyclosporine-A (CsA) and anti-tumour-necrosis-factor (TNF)-alpha agents for the treatment of patients affected by RA and HCV.
  
  
  CONCLUSIONS
  CsA exerts an inhibitory effect on HCV replication and it is safe in patients affected by RA and HCV. Anti-TNF-alpha agents are safe and efficacious in patient with RA and HCV. Anti-TNF-alpha and CsA can be safely given in combination in RA patients with HCV infection.
authors.affiliation: University of Siena, Department of Clinical Medicine and Immunological Science, Rheumatology Section, Policlinico Le Scotte, Siena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Giannitti
authors.forename: Francesca
authors.initials: F
authors.lastname: Bellisai
authors.forename: Clodoveo
authors.initials: C
authors.lastname: Ferri
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D011379:Prognosis; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D016572:Cyclosporine