Hepatitis screening not useful for patients with polyarthritis

The seroprevalence of hepatitis is no higher in patients with recent-onset polyarthritis than in the general population. Therefore, screening patients for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection when evaluating them for polyarthritis suggestive of rheumatoid arthritis (RA) is not useful.

Guennoc and colleagues investigated a longitudinal, prospective cohort of 813 patients for anti-HCV antibodies and HBs antigen. The baseline assessment included a standardized interview, a general physical examination, laboratory tests, and radiographs.

The seroprevalences of HCV and HBV infection in the cohort were 0.86% and 0.12%, respectively, similar to the values reported in the general population. The chemiluminescent microparticle immunoassay result was positive in 16 patients with HCV infection. In this group, the confirmation immunoblot test result was positive in 7 patients, negative in 7, and indeterminate (ultimately negative) in 2. Four of the 7 immunoblot-positive patients had received a diagnosis of HCV-related arthritis. Patients with HCV infection had elevated serum transaminase levels, but only 2 had levels that exceeded 40 IU. Only 1 patient had HBV infection.

The authors noted that knowing which infections are unnecessary to investigate would be helpful.