ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODIES AS A TOOL IN DIFFRENTIATING PATIENTS WITH RHEUMATOID ARTHRITIS FROM PATIENTS WITH CHRONIC HEPATITIS C INFECTION-ASSOCIATED POLYARTICULAR INVOLVEMENT

Objective: To assess the utility of anti-cyclic citrullinated peptide (anti-CCP) antibodies in distinguishingbetween patients with rheumatoid arthritis (RA) and patients with polyarticular involvement associatedwith chronic hepatitis C virus (HCV) infection.Methodology: All the patients enrolled in this study were examined in the outpatient department ofmedicine unit at Lady Reading Hospital Peshawar from February to December 2010. Serum anti-CCPantibodies and rheumatoid factor (RF) were evaluated in 29 patients with RA, 13 patients with chronicHCV infection a associated with articular involvement and 35 patients with chronic HCV infection withoutany joint involvement.Results: Anti-CCP antibodies were detected in18 of 29 (62.1%) patients with RA, 7 of 13(53.8%) patientshaving HCV with RA like arthropathy but not in a single patient with chronic HCV infection with noarticular involvement. Conversely, RF was detected in 25 of 29 (86.2%) patients with RA, 9 of 13 (69.2%)patients with HCV-related RA like arthropathy and 8 of 31 (22.9%) patients with HCV infection withoutjoint involvement.Conclusion: This concludes that anti-CCP antibodies can be useful in discriminating patients with RA frompatients with HCV-associated arthropathy.,