الفهرس 
Definition of HCV infectionOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) is a linear, single-stranded RNA virus that is considered as the most common blood-borne infection and associated with complications such as cirrhosis, liver failure, and hepatocellular carcinoma. It is associated with extra hepatic manifestations which means diseases or conditions that affect organs other than the liver. The most common extra hepatic manifestations are rheumatologic manifestations (arthritis and arthralgia) and also endocrine, hematologic, dermatologic, renal, neurologic, and systemic manifestations. RA is a systemic inflammatory disorder of chronic nature that is characterized primarily by the involvement of synovial joints. Study of the arthritis in patients with chronic infection by hepatitis c virus was the aim of this study in order to evaluate this arthritis, types of joints affected, to find out the mechanisms responsible for this arthritis and to compare it with RA. The study included 40 patients with arthritis, 20 of them with HCV arthritis and the other 20 are RA. They were recruited from the out patient clinics of Physical Medicine and Rehabilitation, internal Medicine Department, Menoufiya University Hospital from the year 2010 - 2011.the diagnosis of HCV was by detection of antibodies by ELISA and evaluated by quantitative PCR and the diagnosis of rheumatoid arthritis (RA) was made according to the American Colleague of Rheumatology in 1988 (ACR) revised criteria for the classification of RA. The study also included 20control subjects matched in age and sex. Patients and controls were subjected to the following: 1-Full medical history taking (age, sex and occupation). 2-Clinical examination. 3- Laboratory investigations: - Serum Cryoglobulins. - Polymerase chain reaction (PCR) (quantitative). - Complete blood count. - Erythrocyte sedimentation rate. - Rheumatoid factor titer (by rose waaler method). - Renal function tests (serum creatinine, blood urea). - Liver function tests (SGOT, SGPT). - Hepatitis C Markers by ELISA. - IGA. - C- reactive protein (high sensitive). 4- Plain-x-ray of the hands and wrists postero-anterior view. 5- Laboratory evaluation by serum cryoglobulins. 6- Statistical analysis of the data. The results showed the following: - The studied patients were aged from 30 to 60 years with disease duration of 6 months to 6 years. -There were statistically significant increase regarding CRP and RF titer between studied patient groups and control (p value <0.001). There were statistically significant increase regarding ESR between group Ι and controls and between group Π and controls but no significant differences between group Ι and group Π patients (p value < 0. 001). -There were statistically significant increase regarding serum cryoglobulins (p value <0.001) between studied patient groups and controls (p-value <0.001). - There were significant positive correlation between serum cryoglobulins and DAS in HCV-AR patients (p-value<0.001) high serum cryoglobulins means higher disease activity. - The HCV-AR is of two types: type is a rheumatoid like arthritis affecting small joints with aspects of differentiation between them and the other type is an intermittent oligoarthritis affecting large joints. - There were no statistically significant differences between serum cryoglobulins and radiological Larsen score (p-value >0.05), so there is no correlation between them. - As regarding clinical findings, types of joints affected and deformity There were statistically significant increase regarding type of joints affected (p value <0.05) and deformity (p value <0.001) between group Ι and group Π but no statistically significant differences regarding NSJ, disease duration, duration of morning stiffness, NTJ between studied patient groups (p value >0.05). This indicates that the HCV-AR patients are not affected with deformity.