Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Hepatitis C Virus-Associated Polyarteritis Nodosa.
Saadoun, David, Terrier, Benjamin, Sene, Damien, Maisonobe, Thierry, Musset, Lucile, Amoura, Zahir, Resche Rigon, Mathieu
To analyse the main characteristics and outcome of polyarteritis nodosa (PAN)-type vasculitis associated with hepatitis C virus (HCV).
We reported characteristics and outcome of 31 patients chronically infected with HCV who satisfied American College of Rheumatology and Chapel Hill criteria of PAN, seen between 1990 and 2009, in a university center.
Among a cohort of 161 patients with HCV-related vasculitis, 31 (19.2%) were diagnosed as having PAN. The median (Q1,Q3) age was 64.5 (49.5, 70.5) years with 54.8% of female. Compared with HCV-mixed cryoglobulinemia (MC) vasculitis, HCV-PAN displayed a more severe and acute clinical presentation with more frequent fever and weight loss (p<0.0001), severe hypertension (p=0.0006), gastrointestinal tract involvement (p<0.0001), severe acute sensory-motor multifocal mononeuropathy (p<0.0001), kidney and liver microaneurisms (p=0.0002) and increased C-reactive protein (p<0.0001). Complete clinical remission of vasculitis was achieved in 79.3% of HCV-PAN compared to 57.5% HCV-MC (p=0.050). In multivariate analysis, skin involvement (OR, 2.81; 95% CI 1.27 to 6.33), and PAN type vasculitis (OR, 3.01; 95% CI 1.16 to 8.96) were independently associated with a complete clinical response of HCV-vasculitis. A glomerular filtration rate lower than 70 ml/min (OR 0.54; 95% CI 0.24 to 1.21) was negatively associated with a complete clinical response of HCV-vasculitis. Clinical relapse rate was higher in HCV-PAN compared to HCV-MC (75% versus 12%, p=0.002, respectively under rituximab). Five-years survival rate was 86% in the whole cohort, regardless of the vasculitis type.
HCV-PAN account for 19.2% of our cohort of HCV vasculitis. HCV-PAN dysplay a more severe and acute clinical presentation and higher rate of clinical remission.
To cite this abstract, please use the following information:
Saadoun, David, Terrier, Benjamin, Sene, Damien, Maisonobe, Thierry, Musset, Lucile, Amoura, Zahir, et al; Hepatitis C Virus-Associated Polyarteritis Nodosa. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2024