BACKGROUND: Patients with systemic lupus erythematosus (SLE) are at risk for the acquisition of hepatitis C, owing to frequent hospitalization and hemotransfusion. Many clinical and laboratory manifestations related to auto-imunity are shared between Lupus and HCV infected patients. OBJECTIVE: To determine the prevalence of hepatitis C in the population with SLE monitored in the out-patient service of the special programs in - Collagenoses - of the University Hospital Clementino Fraga Filho (HUCFF-UFRJ). METHODS: A Cross sectional study was performed, including 91 patients with the diagnosis of probable or definitive SLE (with 3 or more of the 11 diagnostic criteria for SLE used by the American College of Rheumatology - ACR) proceeding from the mentioned center between April / 97 to September / 97. Patients were evaluated on clinical and laboratory basis to determine activity of lupus disease (SLEDAI). All of patients were tested with UBI HCV EIA 4.0 assay and INNO-LIA HCV AbIII confirmatory assay. PCR was performed on all EIA positive INNO-LIA HCV AbIII assay positive patients besides 32 patients negatives in both serological assays. RESULTS: A significative increase in HCV prevalence among SLE patients was observed when compared with a control group of blood donors at HUCFF-UFRJ (6.6 and 1.39%, respectively; p=0,02 and confidence interval of 95%=5.5-13.8 ). However, if confirmative assays (INNO-LIA HCV ABIII and PCR ) are used, this difference can not be observed any more HCV prevalence of 2.2% with confidence interval of 95% = 0.2-7.7 ). CONCLUSIONS: HCV prevalence using ELISA assay for screening showed a significant difference between SLE patients and a blood donors control group ( 6.6 and 1.39% respectively). However, if confirmatory assays are subsequently applied, no difference in HCV prevalence among both groups can be observed. Patients with a possible diagnosis of SLE should have a cost/benefit analisys of testing for HCV.
Hepatitis C; Systemicc lupus erythematosus and auto-immunity
