Usefulness of routine hepatitis C and hepatitis B serology in the diagnosis of recent-onset arthritis. Systematic prospective screening in all patients seen by the rheumatologists of a defined area - Brief report

Objective: Previous studies evaluating the usefulness of systematic screening for hepatitis B and C in patients with recent-onset arthritis suffered from a major bias since they were conducted in hospitals. The objective of the present study was to evaluate the relevance of such screening, performed by hospital and office-based rheumatologists of a defined area, in the diagnosis of arthritis or inflammatory polyarthralgia of less than 1 year duration. Methods: The CRRRI is a network which includes most hospital and office-based rheumatologists of an area with a population of 506,755 inhabitants. All patients seen by the CRRRI participants in their usual practice between March 2008 and December 2010 for inflammatory polyarthralgia, mono-, oligo-, or polyarthritis of less than 1 year duration were included. Patients' serum samples were screened for the presence of anti-hepatitis C virus (HCV) antibodies, with positive samples further evaluated for HCV-RNA with a reverse transcriptase-polymerase chain reaction, and for the presence of hepatitis B virus (HBV) infection. Results: Two hundred and thirty-three patients were included (162 women, 71 men; mean age of 50.6 +/- 15.8 years). Patients were evaluated for inflammatory polyarthralgia (n = 51), monoarthritis (n = 21), oligoarthritis (n = 35) or polyarthritis (n = 126) lasting for a mean 19.8 +/- 29.8 weeks. No new HCV or HBV infection diagnosis was done. Conclusion: In this study not suffering from a hospital-selection bias, screening for hepatitis C and B infection was not helpful in the diagnosis process of recent-onset arthritis. Key messages: Systematic hepatitis B and C serology is not relevant in patients with recent-onset (< 1 year) arthritis. (C) 2011 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.