Differentiation of rheumatoid arthritis from HCV infection: Rheumatoid factor, anti-cyclic citrullinated peptide or anti-mutated citrullinated vimentin? Romatoid artritin HCV enfeksiyonundan ayrılmasında romatoid faktör, anti-siklik sitrüline peptid ve anti-mutated sitrüline vimentinin yeri

Kaptanoǧlu E., Nadir I., Bakici Z., Hayta E., Türkmen M., Sezer H., ...More

Turkish Journal of Rheumatology, vol.25, no.1, pp.19-23, 2010 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 1
  • Publication Date: 2010
  • Journal Name: Turkish Journal of Rheumatology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), TR DİZİN (ULAKBİM), Scopus
  • Page Numbers: pp.19-23
  • Keywords: Anti-CCP, Anti-MCV, HCV, Rheumatoid arthritis, Rheumatoid factor
  • Acibadem Mehmet Ali Aydinlar University Affiliated: No


Objective: Differentiation of rheumatoid arthritis (RA) from other diseases with joint involvement such as hepatitis-C virus (HCV) infection represents a diagnostic problem. In addition to the rheumatoid factor (RF), more specific and sensitive auto-antibodies are under evaluation in recent years with conflicting results. In this study, we tested the diagnostic value of rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) in distinguishing RA from hepatitis C patients. Materials and Methods: Sera of 34 RA patients and 30 hepatitis C patients were tested for RF, anti-CCP anti-MCV. Disease activity was determined by disease activity score (DAS-28) 28 in RA and by modified Knodell score in hepatitis C patients. Extra-articular involvement in RA and rheumatologic involvement in hepatitis C patients were documented. Results: In roc analysis, area under curve (AUC) was the highest in anti-CCP. Sensitivity and specificity was 82% and 53%, 79%, and 96% and 70%, and 73% for RF, anti-CCP and anti-MCV respectively. DAS-28 has a weak correlation with RF (r=0.406), anti-CCP (r=0.433), and anti-MCV (r=0.453). There was no difference between the patients in autoantibody levels regarding extra-articular involvement and DAS-28 in RA, and joint involvement in hepatitis C patients. Conclusion: Anti-MCV antibodies may be useful in distinguishing RA however it seems to have no additional value over anti-CCP or RF in hepatitis C patients. Anti-CCP antibodies are more reliable in diagnosis of RA due to their high specificity.