TY - JOUR T1 - Lack of Specificity of Anticyclic Citrullinated Peptide Antibodies in Advanced Human Immunodeficiency Virus Infection JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.100713 SP - jrheum.100713 AU - Riƫtte du Toit AU - David Whitelaw AU - Jantjie J. Taljaard AU - Lisa du Plessis AU - Monika Esser Y1 - 2011/02/15 UR - http://www.jrheum.org/content/early/2011/02/14/jrheum.100713.abstract N2 - Objective To determine the prevalence and specificity of anticyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) for rheumatoid arthritis (RA) in human immunodeficiency virus (HIV) infection and to evaluate the effect of immune reconstitution on these markers. Methods Patients with advanced HIV infection without arthritis were enrolled. CD4+ T lymphocyte counts (CD4), anti-CCP, and RF were determined before initiating antiretroviral therapy (ART) and repeated after 6 months. Results were compared to those of healthy controls. Patients were followed for the development of RA for 1 year. Results Sixty patients and 26 controls were studied. Six-month followup results were available on 49 patients. Mean (SD) levels of anti-CCP were higher in patients with HIV compared to controls: respectively, 9.50 (11.41) versus 0.80 (1.32) units (p < 0.001). Mean (SD) levels decreased to 4.85 (8.12) units (p = 0.006) after 6 months of ART (HIV-infected group). Fifteen percent of patients initially tested positive for anti-CCP, 4% after 6 months versus no controls (p = 0.031). Forty-seven percent of patients initially tested positive for RF, 18% after 6 months versus 8% of controls (p < 0.001). Decreases in RF and anti-CCP after ART were accompanied by increased mean (SD) CD4: from 129 (56) to 278 (140) cells/mm3 (p < 0.001). Anti-CCP and RF positivity was not associated with the development of RA. Conclusion Increased titers of anti-CCP and RF occur in advanced HIV infection. Although more specific than RF, before immune reconstitution, anti-CCP is an unreliable diagnostic marker for RA and does not necessarily predict future RA. After immune reconstitution, the specificity of anti-CCP approaches that of a control group. ER -