Abstract
ObjectiveThe association between chronic hepatitis virus infection and rheumatoid arthritis (RA) remains debatable. This nationwide population-based cohort study assessed the risk of RA among patients with a chronic infection of hepatitis B and/or C virus.Materials and MethodsWe used data extracted from the claims of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance program. Among the 49,892 persons identified in 2000–2010 with chronic hepatitis virus infection, 35,652 had chronic HBV infection alone, 10,253 had chronic HCV infection alone, and 3,987 had chronic HBV/HCV dual infections. The comparison cohort comprised 199,568 persons matched on sex, age and calendar year without chronic hepatitis virus infection. All study participants were free of RA at baseline and traced through 2011 with new RA cases identified.ResultsAfter adjusting for covariates, chronic HCV infection alone was significantly associated with an increased risk for RA (hazard ratio (HR) = 2.03, 95% confidence interval (CI) = 1.27–3.22). The increased risk for RA among participants with chronic HCV infection remained significant after restricting the analysis to those who were prescribed disease-modifying anti-rheumatic drugs. The corresponding HR for the overall sample was 1.89 (95% CI = 1.15–3.11). However, HBV carriers did not appear to be at a significantly higher risk for RA.ConclusionOur data imply that chronic HCV infection is associated with RA development.
Highlights
Hepatitis B (HBV) and hepatitis C (HCV) virus infections are important global health concerns [1]
Thirty percent of the participants resided in an urbanized region; on the other hand, 22.3% of their counterparts lived in a rural setting
Whether our results hold in other ethnic groups awaits further study. In this nationwide population-based cohort study conducted in a country where both HBV and HCV infections are highly prevalent, we found individuals with chronic HCV infection to be at a significantly higher risk of rheumatoid arthritis (RA)
Summary
Hepatitis B (HBV) and hepatitis C (HCV) virus infections are important global health concerns [1]. It has been estimated that around 350 million people worldwide are chronic HBV carriers with one million people dying annually from HBV-related diseases such as acute hepatitis/chronic hepatitis, cirrhosis of the liver, and hepatocellular carcinoma (HCC) [2]. 75–80% of global HCC cases are attributable to persistent viral infections with either HBV (50–55%) or HCV (25–30%) [4]. In 2007, Taiwan launched a series of community-based screening programs for liver diseases. The results of this screening estimated a 17.3% seroprevalence of HBV and a 4.4% seroprevalence of HCV in the general population aged >18 years [5]. Chronic HBV and HCV infections remain extremely important health problems in Taiwan
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