To the Editor:
Interferon-α (IFN-α) is a group of cytokines with antiviral and antiproliferative effects, used for the treatment of chronic hepatitis C infection and various malignancies1. Immunomodulatory effects of IFN may lead to the induction or exacerbation of autoimmune diseases such as psoriasis, systemic lupus erythematosus, and rarely, rheumatoid arthritis (RA)1. Covalent attachment of a polyethylene glycol (PEG) moiety (pegylation) to IFN-α results in a significantly higher sustained virological response rate in patients with chronic hepatitis C compared to conventional IFN-α2. Pegylation also reduces the immunogenicity of IFN-α2. We describe the first case of a patient who developed anticyclic citrullinated peptide antibody (anti-CCP)-positive RA following treatment of chronic hepatitis C infection with pegylated IFN-α2a.
A 54-year-old Chinese man with chronic hepatitis C (genotype 2a) infection was placed on a 24-week course of PEG-IFN-α2a 180 μg weekly and ribavirin 400 mg BID. His hepatitis C virus (HCV) RNA became undetectable at Week 12 …
Address correspondence to Dr. Arkfeld; E-mail: arkfeld{at}usc.edu