Prevalence and impact of chronic hepatitis C virus infection on the clinical manifestations and disease activity among patients suffering from systemic lupus erythematosus

Abstract

Aim of the work: To study the prevalence of anti-HCV antibodies among patients suffering from systemic lupus erythematosus (SLE) as well as to determine the impact of chronic HCV infection on the clinical manifestations and disease activity.Patients and methods: Ninety-eight consecutive SLE patients presented to the rheumatology department, Cairo University Hospitals were included in the study. All patients were screened for anti-HCV antibodies using a 3rd generation enzyme-linked immune-sorbent assay (ELISA). Patients with positive anti-HCV were tested for the presence of HCV-RNA by polymerase chain reaction (PCR). Patients were classified into two groups; HCV/SLE and non-HCV/SLE according to the presence or absence of anti-HCV antibodies.Results: Twenty/98 patients (20.4%) were positive for HCV antibody. Eight/98 patients (8.2%) had active viremia. SLE patients with positive anti-HCV antibodies tend to be older in age and having a longer SLE duration than non-HCV/SLE Patients. HCV/SLE patients had significantly lower mucocutaneous manifestations (p < 0.05) and higher cardiac manifestations and fundus abnormalities (p < 0.04, p < 0.01 respectively) than non-HCV/SLE patients. There was no statistical difference between the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score between both groups. Patients with HCV/SLE were less frequently on oral steroids than patients with non-HCV/SLE. Conclusion: HCV antibodies and active HCV viremia were found in 20.4% and 8.2% respectively among SLE patients. SLE with positive anti-HCV antibodies tend to be older in age and having longer SLE disease duration, lower mucocutaneous and higher cardiac manifestations and fundus abnormalities. Concomitant chronic HCV infection has no adverse impact on SLEDAI.

Prevalence and risk factors of liver biochemical abnormalities in patients with systemic lupus erythematosus

“…There were two patients, out of the 13 patients with elevated liver enzymes, 15.4% suffering from HCV infection. This percentage was nearly similar to that in a study conducted by El-Garf et al [14] to determine the prevalence of HCV infection in SLE patients, which included 98 patients known to have SLE, and all of them were screened for HCV infection: 20 patients (20.4%) were found to have positive tests for HCV antibodies.…”

Incidence and Risk of Infection in Egyptian Patients with Systemic Lupus Erythematosus

“…In contrast, El Garf et al, in a study on 98 Egyptian SLE patients, reported 20 patients with positive HCV Ab and 8 of them with active viremia 15. This discrepancy could be explained by the fact that HCV Ab testing was not confirmed by HCV PCR testing in all patients of the present study.…”

Gender differences in prevalence of hepatitis C virus infection in Egypt: a systematic review and meta-analysis

“…By title and abstract screening, 308 studies were selected and entered the full-text screening. Only 30 studies 3 – 5 , 8 – 10 , 12 – 15 , 24 , 26 – 44 were finally included in our meta-analysis after full-text screening (Fig. 1 ) with 193,621 included participants: 97,597 male and 96,024 female.…”

“…The salience of gender in positioning women at increased risk of exposure to HCV infection has been confirmed by some studies 3 – 6 , while others support the view that HCV infection appears to be prevalent and progresses more rapidly in males than in females 7 – 11 . On the other hand, some studies found gender differences are artifactual, with nearly flat rates of HCV infection 12 – 15 . Also, some studies found a decreased rate of liver cirrhosis and hepatocellular carcinoma (HCC) in females 16 , more progress to hepatic fibrosis in males, and more liability to adverse events of direct-acting antivirals (DAAs) in females 17 .…”