Evaluation of Rheumatologic Manifestations in Patients With Hepatitis B Infection and Their Relation to Hepatitis B Virus Activity

Abstract

Background: Human hepatitis B virus (HBV) infection shows different extrahepatic manifestations, and rheumatologic features are the most important of them. This study is aimed to identify different rheumatologic manifestations in hepatitis B virus patients and their relation to hepatitis B virus activity.

Methods: This cross-sectional study was performed on 250 patients who were positive for HBV infection and were referred to the Hepatitis Clinic of Imam Khomeini Hospital. If there was any sign of rheumatologic involvement in these patients, they were referred to an expert for further evaluation. The data were analyzed using SPSS (version 20), Student’s t-test, χ² test and Fisher exact test.

Results: The prevalence of arthralgia, rheumatoid factor (RF), serum sickness syndrome and fibromyalgia among HBV patients were 28%, 6%, 3.2%, and 0.4% respectively. Antinuclear antibody (ANA) were found in 5.2% of patients and 18% were positive for anti-cyclic citrullinated peptide (anti CCP). The frequency of rheumatologic manifestations was higher in inactive phase of HBV but we could not find any significant correlation between different stages of HBV. Arthralgia was more frequent in inactive stage of HBV infection (45.7%) and more frequent in female than male (P = 0.001).

Conclusions: In the present study the most frequent rheumatic diseases associated with HBV infection were arthralgia, serum sickness syndrome, and fibromyalgia. The frequency of rheumatic manifestations was higher in inactive phase of HBV. Identification of these manifestations in HBV patients is important since it may facilitate early diagnosis and treatment.




Clin Infect Immun. 2018;3(3-4):69-73
doi: https://doi.org/10.14740/cii67w