Details

Autor(en) / Beteiligte

• Varache, Sophie
• Narbonne, Valérie
• Jousse‐Joulin, Sandrine
• Guennoc, Xavier
• Dougados, Maxime
• Daurès, Jean Pierre
• Devauchelle‐Pensec, Valerie
• Saraux, Alain

Titel

Is routine viral screening useful in patients with recent‐onset polyarthritis of a duration of at least 6 weeks? Results from a nationwide longitudinal prospective cohort study

Ist Teil von

• Arthritis care & research (2010), 2011-11, Vol.63 (11), p.1565-1570

Ort / Verlag

Hoboken, USA: John Wiley & Sons, Inc

Erscheinungsjahr

2011

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Objective To study the contribution of routine viral screening tests in patients with early rheumatoid arthritis (RA) or a potential for progressing to RA. Methods Eight hundred thirteen patients with swelling of at least 2 joints for at least 6 weeks and a symptom duration of less than 6 months in the ESPOIR cohort were screened for parvovirus B19 (IgG and IgM anti–parvovirus B19 antibodies), hepatitis B virus (HBV; hepatitis B surface antigen), hepatitis C virus (HCV; anti‐HCV antibodies), and human immunodeficiency virus (HIV; anti–HIV‐1 and ‐2 antibodies). Results Parvovirus B19 testing was performed in 806 patients and showed longstanding immunity in 574 (71.2%) and no antibodies in 223 (27.7%). Among the 9 remaining patients (7 IgG positive/IgM positive, 1 IgG negative/IgM positive, and 1 IgG indeterminate/IgM positive), only 2 (0.25%; 95% confidence interval [95% CI] 0–0.99%) had a positive polymerase chain reaction test for parvovirus B19; these patients (women ages 34 and 40 years) had no extraarticular signs. HIV seroprevalence was 0.12% (n = 1 of 813; 95% CI 0.01–0.8%) and HCV seroprevalence was 0.86% (n = 7 of 808, 95% CI 0.38–1.86%). HCV‐related arthritis was diagnosed in 4 patients (0.5%). HCV‐seropositive patients had significantly higher transaminase levels than the other patients (P = 0.001), with no significant differences for the other laboratory data. HBV seroprevalence was 0.12% (n = 1 of 808; 95% CI 0.01–0.8%); the positive HBV status was known before study inclusion, and the patient had no diagnosis of HBV‐related arthritis. Finally, routine viral testing identified 2 patients with parvovirus B19 infection and 3 with HBV infection (0.6%; 95% CI 0.2–1.5%). Cost was €85.05 per patient (total €68,720). Conclusion Routine serologic testing did not contribute substantially to the diagnosis in this context.