Serological markers of arthritis in patients with chronic viral hepatitis

UNLABELLED: Wide range of different autoantibodies (e.g. rheumatoid factor, antinuclear antibodies, smooth muscle antibodies, anticardiolipin antibodies) can be detected in low titres in more than 70% of patients with chronic hepatitis. THE AIM OF THE STUDY: Prevalence of serological markers typical for rheumatic diseases in patients with chronic viral hepatitis was examined and the correlation between those markers and serum activity of liver enzymes was evaluated. MATERIAL AND METHODS: 80 patients (30 female and 50 male aged 43.5 +/- 10 years) with chronic viral hepatitis hospitalized in Department of Internal Diseases and Rheumatology of Medical Military Institute in Warsaw were included in the study. 16 of patients were infected with hepatitis virus B, 60 with hepatitis virus C, 4 suffered from both infections. Blood morphology, ESR, CRP aminotransferases activity, protein and bilirubin levels were measured in every patient. Serological examination included levels of antinuclear antibodies (ANA), smooth muscle antibodies (SMA), LKM-1, antineutrophil antibodies (ANCA), anticardiolipin antibodies (aCL), antimitochondrial antibodies (AMA), circulating immunological complexes (CIC), cryoglobulins and rheumatoid factor. RESULTS: At least one serological marker was found in 60 (75%) patients. Latex fixation reaction was positive in 42 (54%), rheumatoid factor was present in 25 (31%), aCL in 28 (34%), pANCA in 22 (27%) and CIC in 16 (20%). Antibodies ANA, AMA, LKM-1 and cryoglobulins were less frequently observed (6%, 5.5% and 7% respectively). The presence of autoantibodies was more frequent in patients with hepatitis C (77% vs. 62%). AMA, LKM-1 and cryoglobulins were detected only in that group of patients. There was no correlation between liver enzymes activity and presence of serological markers of rheumatic diseases. CONCLUSIONS: Serological markers considered to be typical for rheumatic disorders were detected in 75% patients (especially in patients with HCV). There is no correlation between aminotransferases activity and tested serological.