Development of rheumatoid arthritis after chronic hepatitis caused by hepatitis C virus infection.

We describe a patient with rheumatoid arthritis (RA) who had preceding evidence of post-transfusion, non-A, non-B hepatitis. The patient showed positive serological tests for anti-hepatitis C virus (HCV) antibody. The manifestations of RA, including progressive polyarthritis and positive serum rheumatoid factors, emerged after the ameriolation of hepatitis and persisted for more than 3 years, indicating that the polyarthritis in this patient was not the prodrome of the hepatitis. This patient had HLA-DR4 and HLA-Bw54 which are found to be strongly associated with RA in Japan. It is therefore suggested that HCV may trigger the development of RA especially in genetically susceptible individuals.