Abstract
To study the prevalence of anti-HCV antibodies among patients admitted to the rheumatology department, Cairo University hospitals, in 6-month period as well as to determine whether chronic HCV infection was the primary cause of their admission or just a concomitant association with the rheumatic disease. One hundred and fifty-seven patients were included in this study. They represent all patients admitted to the rheumatology inpatient department of Cairo University hospitals during the study period. Preset questionnaire including detailed demographic data, cause of admission and clinical manifestations of their disease was obtained for every patient. All patients were screened for HCV antibodies using ELISA technique. Other laboratory and imaging investigations were done according to the patient’s diagnosis. Twenty-nine patients (18.5%) were positive for HCV antibody. Eleven patients of them (38%) were admitted due to rheumatic manifestations directly related to chronic HCV infection, which represent 7% of all admitted patients (11/157). HCV antibodies were found in 17.6 and 6.7% among patients with rheumatoid and systemic lupus erythematosus. Arthritis, palpaple purpura, digital gangrene and mononeuritis multiplex were the most common causes of admission related to chronic HCV infection. HCV antibodies were found in 18.5% among admitted patients to the rheumatology ward. The rheumatic manifestations of chronic HCV represent the primary cause of admission in 7% of all admitted patients. HCV screening should be included in the routine investigations for patients presenting to rheumatology departments in countries with high prevalence of chronic HCV infection.
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Rustgi VD (2007) The epidemiology of hepatitis C infection in the United States. J Gastroenterol 42:513–521
Strickland GT, Elhefni H, Salman T, Waked I, Abdel-Hamid M, Mikhail NN et al (2002) Role of hepatitis C infection in chronic liver disease in Egypt. Am J Trop Med Hyg 67(4):436–442
Strickland GT (2006) Liver disease in Egypt: hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors. Hepatology 43(5):915–922
Armstrong GL, Walsley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ (2006) The prevalence of hepatitis C virus infection in the United States, 199 through 2002. Ann Intern Med 144(10):705–714
Shalaby S, Kabbash IA, El Saleet G, Mansour N, Omar A, El Nawawy A (2010) Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governerate, Egypt. East Mediterr Health J 16(1):10–17
El-Zayadi A, Simmonds P, Dabbous H, Prescott L, Selim O, Ahdy A (1996) Response to interferon-a of Egyptian patients infected with hepatitis C virus genotype 4. J Viral Hepat 3:261–264
Angelico M, Renganathan E, Gandin C, Fathy M, Profili MC, Refai W et al (1997) Chronic liver disease in the Alexandria governorate, Egypt: contribution of schistosomiasis and hepatitis virus infections. J Hepatol 26(2):236–243
Ray SC, Arthur RR, Carella A, Bukh J, Thomas DL (2000) Genetic epidemiology of hepatitis C virus throughout Egypt. J Infect Dis 182:698–707
Kamal SM, Madwar MA, Peters T, Fawzy R, Rasenack J (2000) Interferon therapy in patients with chronic hepatitis C and schistosomiasis. J Hepatol 32:172–174
McCarthy MC, El Tigani A, Khalid IO, Hyams KC (1994) Hepatitis B and C in Juba, southern Sudan: results of a serosurvey. Trans Roy Soc Top Med Hyg 88:534–536
World Health Organization (WHO) (1997) Hepatis C global prevalence. Wkly Epidemiological Rec 72:341–344
Shobokshi O, Serebour E, Shakni L, Al Saffy Y, Ahdai M (1999) Hepatitis C genotypes and subtypes in Saudi Arabia. J Med Virol 58(1):44–48
Quinti I, Renganathan E, El Ghazzawi E, Divizia M, Sawaf G, Awad S et al (1995) Seroprevalence of HIV and HCV infections in Alexandria, Egypt. Zentralbl Bakteriol 283(2):239–244
Frank C, Mohamed MK, Strickland GT, Lavanchy D, Arthur R, Magder L et al (2000) The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet 355(9207):887–891
Nafeh MA, Medhat A, Shehata M, Mikhail NN, Swifee Y, Abdel-Hamid M et al (2000) Hepatitis C in a community in upper Egypt: I. cross-sectional survey. Am J Trop Med Hyg 63(5–6):236–241
Habib M, Mohamed MK, Abdel-Aziz F, Magder LS, Abdel-Hamid M, Madkour S et al (2001) Hepatitis C virus infection in a community in the Nile Delta: risk factors for seropositivity. Hepatology 33:248–253
Cacoub P, Renou C, Rosenthal E, Cohen P, Loury I, Loustaud-Ratti V et al (2000) Extrahepatic manifestations associated with hepatitis C virus infection. A prospective multicenter study of 321 patients. The GERMIVIC. Medicine (Baltimore) 79(1):47–56
Ramos-Casals M, Font J (2005) Extra-hepatic manifestations in patients with chronic hepatitis C virus infection. Curr Opin Rheumatol 17(4):447–455
Sterling RK, Bralow S (2006) Extrahepatic manifestations of hepatitis C virus. Curr Gastroenterol Rep 8(1):53–59
Buskila D, Shnaider A, Neumann L, Lorber M, Zilberman D, Hilzenrat N et al (1998) Musculoskeletal manifestations and autoantibody profile in 90 hepatitis C virus-infected Israeli patients. Semin Arthritis Rheum 28(2):107–113
Buskila D (2000) Hepatitis C-associated arthritis. Curr Opin Rheumatol 12(4):295–299
Lormeau C, Falgarone G, Roulot D, Boissier MC (2006) Rheumatologic manifestations of chronic hepatitis C infection. Joint Bone Spine 73(6):633–638
Buskila D (2009) Hepatitis C-associated rheumatic disorders. Rheum Dis Clin North Am 35(1):111–123
Ramos-Casals M, Jara LJ, Medina F, Rosas J, Calvo-Alen J, Mana J et al (2005) Systemic autoimmune diseases coexisting with chronic hepatitis C virus infection (the HISPAMIC Registry): patterns of clinical and immunological expression in 180 cases. J Intern Med 257(6):549–557
Barbosa VS, da Silva NA, Martins RMB (2005) Hepatitis C virus seroprevelance and genotypes in patients with diffuse connective tissue diseases and spondyloarthopathies. Braz J Med Biol Res 38(5):801–805
Pryor B, Bologna AG, Kahl LE (1996) Risk factors for serious infection during treatment with cyclophosphamide and high-dose corticosteroids for systemic lupus erythematosus. Arthritis Rheum 39:1475–1482
Cansu DU, Kalifoglu T, Korkmaz C (2008) Short-term course of chronic hepatitis B and C under treatment with etanercept associated with different disease modifying antirheumatic drugs without antiviral prophylaxis. J Rheumatol 35(3):421–424
Cheney CP, Chopra S, Graham C (2000) Hepatis C. Infect Dis Clin North Am 14(3):633–667
Silini E, Locasciulli A, Santoleri L, Gargantini L, Pinzello G, Montillo M et al (2002) Hepatitis C virus infection in a hematology ward: evidence for nosocomial transmission and impact on hematologic disease outcome. Haematologica 87(11):1200–1208
Allander T, Gruber A, Naghavi M, Beyene A, Soderstrom T, Bjorkholm M et al (1995) Frequent patient-to-patient transmission of hepatitis C virus in a haematology ward. Lancet 345(8950):603–607
Knoll A, Helmig M, Peters O, Jilg W (2001) Hepatitis C virus transmission in a pediatric oncology ward: analysis of an outbreak and review of the literature. Lab Invest 81(3):251–262
Girou E, Chevaliez S, Challine D, Thiessart M, Morice Y, Lesprit P et al (2008) Determinant roles of environmental contamination and noncompliance with standard precautions in the risk of hepatitis C virus transmission in a hemodialysis unit. Clin Infect Dis 47(5):627–633
Ross RS, Viazov S, Khudyakov YE, Xia GL, Lin Y, Holzmann H et al (2009) Transmission of hepatitis C virus in an orthopedic hospital ward. J Med Virol 81(2):249–257
Steeff LB (2002) Natural history of chronic hepatitis C. Hepatology 36(5 Suppl 1):S35–S46
Lewis-Ximenez LL, Lauer GM, Schulze Zur Wiessch J, de Sousa PS, Ginuino CF, Paranhos-Baccala G et al (2010) Prospective follow-up of patients with acute hepatitis C virus infection in Brazil. Clin Infect Dis 50(9):1222–1230
Maillefert JF, Muller G, Falgarone G, Bour JB, Ratovohery D, Dougados M et al (2002) Prevalence of hepatitis C virus infection in patients with rheumatoid arthritis. Ann Rheum Dis 61(7):635–637
Palazzi C, D’Amico E, D’Angelo S, Nucera A, Petricca A, Olivieri I (2008) Hepatitis C virus infection in Italian patients with fibromyalgia. Clin Rheumatol 27(1):101–103
Abu shakra M, El-Sana S, Margalith M, Silkuler E, Neumann L, Buskila D (1997) Hepatitis B and C viruses serology in patients with SLE. Lupus 6(6):543–544
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El Garf, A., El Zorkany, B., Gheith, R. et al. Prevalence and clinical presentations of hepatitis C virus among patients admitted to the rheumatology ward. Rheumatol Int 32, 2691–2695 (2012). https://doi.org/10.1007/s00296-011-2014-8
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DOI: https://doi.org/10.1007/s00296-011-2014-8