title: Prevalence of rheumatologic manifestations of chronic hepatitis C virus infection among Egyptians.
abstract: Chronic hepatitis C virus (HCV) viremia has been known to provoke a plethora of autoimmune syndromes referred to as extrahepatic manifestations of chronic HCV infection. Aim of the current study was to assess the prevalence of rheumatologic manifestations among Egyptians with hepatitis C infection and its' association with cryoglobulin profile. The current research represents a cross-sectional study where patients with chronic HCV infection attending the outpatient clinic of the National Hepatology and Tropical Medicine Research Institute over a period of 1 year were interviewed. Patients with decompensated liver disease, on interferon therapy, having end-stage renal disease or coexisting viral infection like hepatitis B surface antibody positive patients were all excluded from the research. Laboratory investigations as well as serological assay including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed. Three hundred and six patients having chronic HCV infection were interviewed in this research. The overall estimated prevalence of rheumatologic manifestations in the current research was 16.39%, chronic fatigue syndrome 9.5%, sicca symptoms 8.8%, arthralgia 6.5%, fibromyalgia 1.9%, myalgia 1.3%, arthritis 0.7%, cryoglobulinemic vasculitis 0.7%, autoimmune hemolytic anemia 0.7%, thrombocytopenia 0.7%. Xerophthalmia was significantly present in male population (p = 0.04), whereas fibromyalgia, cryoglobulinemic vasculitis, arthritis, and autoimmune hemolytic anemia were significantly present in female population under study (p < 0.05). In chronic HCV genotype 4 infection, the prevalence of rheumatologic manifestations was 16.3% with chronic fatigue syndrome and sicca symptoms being the most common with no significant correlation to the degree of elevation of liver disease or viral load.
authors.affiliation: Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University Hospitals, Cairo, Egypt. rmhamdy@yahoo.com
authors.forename: Reem Hamdy Abdellatif
authors.initials: RH
authors.lastname: Mohammed
authors.forename: Hesham Ibrahim
authors.initials: HI
authors.lastname: ElMakhzangy
authors.forename: Amira
authors.initials: A
authors.lastname: Gamal
authors.forename: Fatma
authors.initials: F
authors.lastname: Mekky
authors.forename: Mohammed
authors.initials: M
authors.lastname: El Kassas
authors.forename: Nabil
authors.initials: N
authors.lastname: Mohammed
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abdel Hamid
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003449:Cryoglobulinemia / Q000150:complications / Q000453:epidemiology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
references.citation: Eur J Haematol. 2005 Nov;75(5):417-23
references.pmid: 16191092
references.citation: Reumatismo. 2001;53(1):26-32
references.pmid: 12461575
references.citation: J Virol. 2002 Nov;76(21):11148-54
references.pmid: 12368359
references.citation: Ital J Gastroenterol Hepatol. 1998 Aug;30(4):391-5
references.pmid: 9789135
references.citation: Ann Intern Med. 1995 Oct 15;123(8):615-20
references.pmid: 7677303
references.citation: Semin Arthritis Rheum. 1997 Feb;26(4):689-701
references.pmid: 9062950
references.citation: J Med Virol. 2006 Sep;78(9):1185-9
references.pmid: 16847958
references.citation: J Infect Dis. 2000 Sep;182(3):698-707
references.pmid: 10950762
references.citation: Am J Med. 2004 Jul 1;117(1):10-3
references.pmid: 15210382
references.citation: Med Klin (Munich). 2006 Mar 15;101(3):212-25
references.pmid: 16648979
references.citation: Hepatology. 1995 Mar;21(3):613-9
references.pmid: 7533120
references.citation: J Viral Hepat. 1997 Jan;4(1):9-28
references.pmid: 9031061
references.citation: Br J Rheumatol. 1997 Sep;36(9):981-5
references.pmid: 9376995
references.citation: J Hepatol. 2004 Feb;40(2):341-52
references.pmid: 14739110
references.citation: J Infect Dis. 1990 Aug;162(2):569-70
references.pmid: 2115556
references.citation: Joint Bone Spine. 2006 Dec;73(6):633-8
references.pmid: 17056293
references.citation: Semin Arthritis Rheum. 1998 Oct;28(2):107-13
references.pmid: 9806371
references.citation: World J Gastroenterol. 2007 Dec 28;13(48):6518-28
references.pmid: 18161922
references.citation: Hepatol Res. 2002 Sep;24(1):23
references.pmid: 12243789
references.citation: Gastroenterology. 2003 Dec;125(6):1723-32
references.pmid: 14724825
references.citation: Medicine (Baltimore). 2000 Jan;79(1):47-56
references.pmid: 10670409
references.citation: Rev Med Interne. 2007 Jun;28(6):388-93
references.pmid: 17137683
references.citation: Arthritis Rheum. 1999 Oct;42(10):2204-12
references.pmid: 10524695
references.citation: Dig Liver Dis. 2007 Jan;39(1):2-17
references.pmid: 16884964
references.citation: Ann Intern Med. 1995 Feb 1;122(3):169-73
references.pmid: 7810933
references.citation: Curr Gastroenterol Rep. 2006 Feb;8(1):53-9
references.pmid: 16510035
references.citation: Medicine (Baltimore). 2005 Mar;84(2):81-89
references.pmid: 15758837
references.citation: Clin Exp Rheumatol. 2003 Nov-Dec;21(6 Suppl 32):S89-94
references.pmid: 14740433
references.citation: Clin Exp Immunol. 2002 May;128(2):347-52
references.pmid: 11985526
references.citation: Reumatismo. 2002 Oct-Dec;54(4):316-23
references.pmid: 12563365
references.citation: J Rheumatol. 2009 Jul;36(7):1442-8
references.pmid: 19369460
references.citation: World J Gastroenterol. 2007 May 7;13(17):2467-78
references.pmid: 17552031
references.citation: J Gastrointestin Liver Dis. 2007 Mar;16(1):65-73
references.pmid: 17410291
references.citation: J Hepatol. 1996 Feb;24(2):135-40
references.pmid: 8907565
references.citation: Semin Liver Dis. 2000;20(1):1-16
references.pmid: 10895428