Usefulness of routine hepatitis C and hepatitis B serology in the diagnosis of recent-onset arthritis. Systematic prospective screening in all patients seen by the rheumatologists of a defined area--brief report

Abstract

Objective: Previous studies evaluating the usefulness of systematic screening for hepatitis B and C in patients with recent-onset arthritis suffered from a major bias since they were conducted in hospitals. The objective of the present study was to evaluate the relevance of such screening, performed by hospital and office-based rheumatologists of a defined area, in the diagnosis of arthritis or inflammatory polyarthralgia of less than 1 year duration.

Methods: The CRRRI is a network which includes most hospital and office-based rheumatologists of an area with a population of 506,755 inhabitants. All patients seen by the CRRRI participants in their usual practice between March 2008 and December 2010 for inflammatory polyarthralgia, mono-, oligo-, or polyarthritis of less than 1 year duration were included. Patients' serum samples were screened for the presence of anti-hepatitis C virus (HCV) antibodies, with positive samples further evaluated for HCV-RNA with a reverse transcriptase-polymerase chain reaction, and for the presence of hepatitis B virus (HBV) infection.

Results: Two hundred and thirty-three patients were included (162 women, 71 men; mean age of 50.6±15.8 years). Patients were evaluated for inflammatory polyarthralgia (n=51), monoarthritis (n=21), oligoarthritis (n=35) or polyarthritis (n=126) lasting for a mean 19.8±29.8 weeks. No new HCV or HBV infection diagnosis was done.

Conclusion: In this study not suffering from a hospital-selection bias, screening for hepatitis C and B infection was not helpful in the diagnosis process of recent-onset arthritis.

Key messages: Systematic hepatitis B and C serology is not relevant in patients with recent-onset (<1 year) arthritis.