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Systemic lupus erythematosus (SLE) is a disease of unknown aetiology characterised by impaired immune regulation and production of polyclonal autoantibodies. It is reported in the medical literature that in patients with chronic hepatitis resulting from hepatitis C virus (HCV) more autoantibodies such as antinuclear antibodies, anti-ds DNA, antiphospholipid antibody, antithyroglobulin antibody, rheumatoid factor, cryoglobulinaemia, and anti-GOR (an HCV induced, host derived epitope) are seen than in patients with other causes of hepatitis virus.1-3 There have also been reports on HCV associated with several immunological diseases including membranoproliferative glomerulonephritis,4 polyarteritis nodosa,5 essential mixed cryoglobulinaemia,6 Sjögren’s syndrome,7and rheumatoid arthritis.8 There are not enough data, however, on the frequency of HCV infection in SLE cases. Therefore, we planned a study to investigate prevalence of anti-HCV in SLE cases.
Thirty eight patients (36 female) with SLE were included in the study. Their mean (SD) age was 31 (12) years (range 8–64). Diagnosis of SLE was made according to revised criteria of the American Rheumatology Association.9 The most common clinical and laboratory findings include arthralgia (59%), fever (58%), cutaneous manifestations (20%), leucopenia (40%), lupus nephritis (65%), antinuclear antibodies (80%), anti-DNA (49%), and low values of C3 and C4 (40%).
Antibodies against HCV encoded antigens (c100, 33c, c22) were assessed by the second generation Abbott enzyme linked immunosorbent assay (ELISA) according to manufacturer’s instructions. It was estimated that the prevalence of anti-HCV antibodies (second generation ELISA) in the healthy population was 1.4% in our region. The χ2test was used to perform statistical comparison. Table 1 shows the findings.
Anti-HCV was found to be positive in only one (2.6%) patient. She was 33 years of age. No transmission risk was found except for spinal surgery one year before the symptoms and signs of the disease began. She had not received any blood, and there was no abnormality in the liver function tests during her follow up.
We found no significant difference between healthy population and SLE patients in terms of prevalence of anti-HCV (p>0.05). In the medical literature, we could not find any study about the prevalence of anti-HCV in SLE patients. However, Michel et al 10 in their study about anti-GOR and HCV in autoimmune liver diseases have reported no anti-HCV in 10 SLE patients.
Our results showed that the prevalence of the anti-HCV in patients with SLE was not higher than that of the general population, and the relation between HCV and SLE could not be established.