Rheumatoid arthritis following a treatment with IFN-alpha/ribavirin against HCV infection

Intern Med. 2011;50(9):1065-8. doi: 10.2169/internalmedicine.50.4790. Epub 2011 May 1.

Abstract

We report a 48-year-old man who developed rheumatoid arthritis (RA) after a successful treatment with peg-IFN-alpha plus ribavirin for chronic hepatitis C virus (HCV) infection. He had a history of smoking and a single copy of the HLA-DRB1 shared epitope (SE). In a retrospective analysis, he exhibited the anti-CCP antibodies before the start of IFN plus ribavirin treatment. However, the titers of anti-CCP antibodies and BAFF levels were elevated by the IFN plus ribavirin therapy. These observations suggest that IFN plus ribavirin therapy may work as a "trigger" for RA in genetically and environmentally predisposed individuals by affecting the cytokine network.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / adverse effects*
  • Arthritis, Rheumatoid / etiology*
  • Arthritis, Rheumatoid / immunology
  • Arthritis, Rheumatoid / pathology
  • Autoantibodies / blood
  • B-Cell Activating Factor / blood
  • Cytokines / metabolism
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / immunology
  • Humans
  • Interferon Type I / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Peptides, Cyclic / immunology
  • Recombinant Proteins
  • Ribavirin / adverse effects*
  • Risk Factors

Substances

  • Antiviral Agents
  • Autoantibodies
  • B-Cell Activating Factor
  • Cytokines
  • Interferon Type I
  • Peptides, Cyclic
  • Recombinant Proteins
  • TNFSF13B protein, human
  • cyclic citrullinated peptide
  • Ribavirin