Hepatitis C virus and arthritis

Arthritis is one of the most frequent extrahepatic manifestations of hepatitis C virus (HCV) infection. There is not a specific clinical pattern of HCV-related arthritis, but two nonerosive subsets have frequently been described: a rheumatoid arthritis-like polyarthritis and a less common mono-oligoarthritis involving medium-sized and large joints. Because of its variable characteristics, HCV-related arthritis must be considered in the differential diagnosis of any patient having inflammatory joint involvement. Nonsteroidal anti-inflammatory drugs, hydroxychloroquine, and low doses of corticosteroids are the cornerstones of the treatment of HCV-related arthritis. An antiviral therapy with alpha-interferon and ribavirin is useful when required by hepatic or systemic involvement.