Abstract
BackgroundTo study the most common rheumatologic manifestations of hepatitis C viral (HCV) infection in Egyptian patients and associated risk factors with assessment the effect of current therapies on these manifestations. A prospective study was carried out to HCV patients attending the tropical medicine department referred to rheumatology department, over a year. A total of 204 hepatitis C virus treatment-naïve patients aged 21–71 years old suffering from rheumatologic manifestations were recruited, and history taking, general and musculoskeletal examination, laboratory and serological investigations, imaging, and liver fibrosis findings were assessed: baseline, end of treatment, and 12 weeks later, either sofosbuvir/ribavirin or sofosbuvir/simeprevir regimens and through three consecutive visits: joint activity and functional scores were taken.ResultsCommon observed rheumatologic manifestations were fibromyalgia (74.5%), arthralgia (73.5%), Raynaud’s phenomenon (54.9%), peripheral neuropathy (29.4%),chronic fatigue syndrome and purpura (24.5%), arthritis (16.7%), Sicca symptoms and skin ulcers (9.8%), and vasculitic CNS involvement (5.9%), mostly seen in females. VAS and FAS scales have improved across visits (p value < 0.001) with lowered number and percentage of arthralgia (tender joint counts), arthritis (swollen joint counts), improvement of fibromyalgia, purpura, peripheral neuropathy, anemia, and thrombocytopenia (p < 0.001). Common reported risk factors were barber shaving (52 %), dental procedures (44.1%), and surgical interventions (36.3%). Non-reactive cases shown by HCV-PCR response increased at the end of study reaching 62%. The percent of improvement was significantly higher in patients receiving sofosbuvir/simeprevir regimen (100%) versus sofosbuvir/ribavirin (58.2%).ConclusionDirect antiviral drugs seem to improve the rheumatic extra-hepatic manifestations of HCV patients and lowering viremia level especially sofosbuvir/simeprevir regimen in hepatitis C treatment-naïve patients.
Highlights
To study the most common rheumatologic manifestations of hepatitis C viral (HCV) infection in Egyptian patients and associated risk factors with assessment the effect of current therapies on these manifestations
Inclusion criteria hepatitis C virus (HCV) treatment- naïve patients who never took an antiviral treatment for hepatitis C before were included, and the most discovered and associated important risk factors causing those prone subjects to be infected were asked to be included in this study
Two hundred and four newly diagnosed hepatitis C patients were investigated for extra-hepatic rheumatic manifestations: 100 (49.0%) were males, and the 104 (51.0%) were females
Summary
To study the most common rheumatologic manifestations of hepatitis C viral (HCV) infection in Egyptian patients and associated risk factors with assessment the effect of current therapies on these manifestations. It was shown that HCV infection was associated with death from hepatic and from extrahepatic diseases [6]. This seemed to be a significant endemic medical issue in Egypt: an Egyptian demographic health survey done in 2008 from both urban and rural areas has demonstrated that 14.7% of the population has been infected, making this the highest prevalence in any population in the world [7,8,9]. HCV viremia may provoke non-specific rheumatologic manifestations described as extra-hepatic ones [11]; nonspecific serological abnormalities can occur and/or manifested clinical disease, affecting multiple organs and systems [12]
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