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Abstract Number: 2223

High Prevalence of Hepatitis C Virus Infection in a Japanese Inclusion Body Myositis Cohort

Akinori Uruha1, Satoru Noguchi2, Yukiko K. Hayashi3, Ikuya Nonaka2 and Ichizo Nishino2, 1Department of Clinical Development, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan, 2Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan, 3Department of Neurophysiology, Tokyo Medical University, Tokyo, Japan

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Hepatitis C, infection and myositis

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Session Information

Session Title: Muscle Biology, Myositis and Myopathies: Immunological Aspects of Inflammatory Myopathy

Session Type: Abstract Submissions (ACR)

Background/Purpose

There have been several case reports of inclusion body myositis (IBM) that appeared after chronic hepatitis C virus (HCV) infection. However, the relationship between HCV infection and IBM remains unclear. In this study, we assessed the prevalence of HCV infection in IBM patients and re-evaluated the clinicopathological aspects of HCV-positive IBM by using our cohort.

Methods

We analyzed the presence/ absence of anti-HCV antibodies of 118 patients (mean age 69.0±8.1y) who were pathologically diagnosed as IBM in 2002 to 2012. As a control, we analyzed likewise 44 age-matched patients (69.0±7.5y) who were pathologically diagnosed as polymyositis in the same period. Then we compared HCV-positive IBM group with HCV-negative group in terms of clinicopathological features including intervals in years from first symptom onset to each onset of symptoms characteristic for IBM and frequencies of fibers with rimmed vacuoles and ragged-red fibers.

Results

In IBM group, anti-HCV antibodies were detected in 34 patients (28.8%). This rate was higher than that of the polymyositis group and of the Japanese general population in the sixties (4.5% and 3.4%, respectively) (p < 0.001). No significant difference was seen between HCV-positive and -negative IBM groups, in terms of age at onset (66.6±8.0 vs. 64.1±8.6 years of age), sex ratio (1.4: 1 vs. 1.4: 1), periods after onset showing inability to squat (3.8±3.6 vs. 3.9±2.5 years), inability to open a bottle (4.2±3.2 vs. 4.1±2.3 years), dysphagia (4.9±4.8 vs. 4.5±2.3 years), non-ambulatory (6.1±4.0 vs. 7.1±3.2 years), and pathological findings including the frequency of fibers with rimmed vacuoles [1.7 (0.17-8.1) vs. 2.2 (0.2-23.6)%] and that of ragged-red fibers [0.5 (0.1-5.7) vs. 0.4 (0-4.8)%].

Conclusion

Our results confirm the association between HCV infection and IBM, and suggest a possible causal role of HCV infection in the pathogenesis of IBM.


Disclosure:

A. Uruha,
None;

S. Noguchi,
None;

Y. K. Hayashi,
None;

I. Nonaka,
None;

I. Nishino,
None.

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