[Detection of antibodies to cyclic citrullinated peptides and its clinical significance in patients with chronic hepatitis B virus infection].

OBJECTIVE: To detect the presence of antibodies to cyclic citrullinated peptides (anti-CCP) in patients with chronic hepatitis B virus (HBV) infection and evaluate its potential clinical significance.

METHODS: Serum samples of 280 patients with chronic HBV infection and 40 healthy controls were collected from May 2011 to October 2011 and tested for anti-CCP and IgM-rheumatoid factor (RF). Anti-CCP was detected by ELISA and RF by immunonephelometry. All of 280 patients with chronic HBV infection were divided into 3 groups according to joint symptoms: asymptomatic group, HBV-associated arthropathy group and HBV concomitant RA group. Meanwhile, according to liver disease, they were divided into 3 groups: carrier group, chronic hepatitis group and cirrhosis group.

RESULTS: The positive rates of anti-CCP and RF were 5.7% and 13.9% in patients with chronic HBV infection respectively. Anti-CCP was detected in 3 of 265 non-RA (1.1%) and 13 of 15 RA patients (86.7%). And RF were detected in 27 of 265 non-RA (10.2%) and 12 of 15 RA patients (80.0%). Twelve of 15 RA patients were positive for both anti-CCP and RF. The specificity of anti-CCP for RA was 98.9% in chronic HBV infection while the specificity of RF 89.8% (P < 0.01). Compared with the positive detection rates of anti-CCP and RF among liver disease subgroups, no significant difference existed between the subgroups. The levels of anti-CCP and RF in HBV concomitant RA group were statistically higher than those in asymptomatic group, HBV-associated arthropathy group and healthy controls (all P < 0.01). The level of RF in patients with HBV-associated arthropathy group was higher than that in asymptomatic group (U = 6017, P < 0.05).

CONCLUSION: It is better to detect anti-CCP than RF to discriminate non-RA from concomitant RA in patients with chronic HBV infection.