Prevalence of Rheumatoid Arthritis and Hepatitis C in Those Age 60 and Older in a US Population Based Study

FLORENCE C. HSU, GORDON STARKEBAUM, EDWARD J. BOYKO, and JASON A. DOMINITZ

ABSTRACT.

Objective. A positive association between rheumatoid arthritis (RA) and hepatitis C virus (HCV) infection has been reported in clinic based cross sectional studies. We investigated if RA and HCV are associated in a population based survey.

Methods. Using data from the National Health and Nutrition Examination Survey III, hepatitis C and RA status were determined for subjects ³ 60 years of age. RA was defined to be present when 3 of 6 American College of Rheumatology (ACR) criteria were met.

Results. Of 6596 subjects, 1827 (27.7%) were excluded due to missing data. Of the remaining 4769, 196 subjects (4.1%) met our modified ACR criteria for probable RA: 63 tested positive for anti-HCV antibodies (1.3%) while 35 were HCV RNA positive (0.7%). Two subjects had both HCV antibodies and RA, while one subject was both HCV RNA positive and had RA. HCV antibody positivity was not associated with RA (OR 0.44, 95% CI 0.07-2.80). Similarly, HCV positivity by polymerase chain reaction was not associated with RA (OR 0.77, 95% CI 0.10-6.19).

Conclusion. These results argue against a potential role for HCV in the etiology of RA in the US population aged 60 years and over. (J Rheumatol 2003;30:455-8)

Key Indexing Terms:

HEPATITIS C VIRUS
RHEUMATOID ARTHRITIS
RHEUMATOID FACTOR

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From the Seattle Epidemiologic Research and Information Center and the Arthritis and Gastroenterology Sections, VA Puget Sound Health Care System; and the Division of Rheumatology, University of Washington, Seattle, Washington, USA.

Supported by VA grant EPC-010, Epidemiologic Research and Information Center.

F.C. Hsu, MD; G. Starkebaum, MD, VA Puget Sound Health Care System and Department of Medicine, Division of Rheumatology, University of Washington School of Medicine; E.J. Boyko, MD, MPH, Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine; J.A. Dominitz, MD, MHS, Northwest Hepatitis C Resource Center, Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Department of Medicine, Division of Gastroenterology, University of Washington School of Medicine.

Address reprint requests to Dr. J.A. Dominitz, VA Puget Sound Health Care System, 111-Gastro, 1660 South Columbian Way, Seattle, WA 98108-1532. E-mail: jason.dominitz@med.va.gov

Submitted November 2, 2001; revision accepted August 23, 2002.

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