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Erschienen in: Arthritis Research & Therapy 5/2008

01.10.2008 | Review

Virally associated arthritis 2008: clinical, epidemiologic, and pathophysiologic considerations

verfasst von: Dimitrios Vassilopoulos, Leonard H Calabrese

Erschienen in: Arthritis Research & Therapy | Ausgabe 5/2008

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Abstract

Several viruses have been associated with the development of inflammatory arthritis, including the hepatitis viruses (hepatitis B virus and hepatitis C virus), HIV, the parvovirus B19, the human T-cell lymphotropic virus-I, and the alphaviruses. Here, we review the epidemiology, the pathophysiological mechanisms, the pertinent clinical and laboratory findings as well as the principles of therapy of the most common virus-associated arthritides. We believe that the knowledge of these key diagnostic and therapeutic features of virus-associated arthritides is important for the rheumatologist of the 21st century.
Literatur
1.
Zurück zum Zitat Strauss JH, Strauss EG: Overview of viruses and virus infection. Viruses and Human Disease. Edited by: Strauss JH, Strauss EG. 2008, Burlington, MA: Elsevier Science, 1-31.CrossRef Strauss JH, Strauss EG: Overview of viruses and virus infection. Viruses and Human Disease. Edited by: Strauss JH, Strauss EG. 2008, Burlington, MA: Elsevier Science, 1-31.CrossRef
2.
Zurück zum Zitat Calabrese LH, Naides SJ: Viral arthritis. Infect Dis Clin North Am. 2005, 19: 963-980. 10.1016/j.idc.2005.09.002.CrossRefPubMed Calabrese LH, Naides SJ: Viral arthritis. Infect Dis Clin North Am. 2005, 19: 963-980. 10.1016/j.idc.2005.09.002.CrossRefPubMed
3.
Zurück zum Zitat Lundqvist A, Isa A, Tolfvenstam T, Kvist G, Broliden K: High frequency of parvovirus B19 DNA in bone marrow samples from rheumatic patients. J Clin Virol. 2005, 33: 71-74. 10.1016/j.jcv.2004.11.011.CrossRefPubMed Lundqvist A, Isa A, Tolfvenstam T, Kvist G, Broliden K: High frequency of parvovirus B19 DNA in bone marrow samples from rheumatic patients. J Clin Virol. 2005, 33: 71-74. 10.1016/j.jcv.2004.11.011.CrossRefPubMed
4.
Zurück zum Zitat Rulli NE, Melton J, Wilmes A, Ewart G, Mahalingam S: The molecular and cellular aspects of arthritis due to alphavirus infections: lesson learned from Ross River virus. Ann N Y Acad Sci. 2007, 1102: 96-108. 10.1196/annals.1408.007.CrossRefPubMed Rulli NE, Melton J, Wilmes A, Ewart G, Mahalingam S: The molecular and cellular aspects of arthritis due to alphavirus infections: lesson learned from Ross River virus. Ann N Y Acad Sci. 2007, 1102: 96-108. 10.1196/annals.1408.007.CrossRefPubMed
6.
Zurück zum Zitat Vassilopoulos D: Rheumatic manifestations of acute and chronic viral arthritis. Current Rheumatology Diagnosis & Treatment. Edited by: Imboden J, Hellmann D, Stone J. 2007, New York, NY: The McGraw-Hill Companies, Inc, 388-395. Vassilopoulos D: Rheumatic manifestations of acute and chronic viral arthritis. Current Rheumatology Diagnosis & Treatment. Edited by: Imboden J, Hellmann D, Stone J. 2007, New York, NY: The McGraw-Hill Companies, Inc, 388-395.
7.
Zurück zum Zitat Mason A, Theal J, Bain V, Adams E, Perrillo R: Hepatitis B virus replication in damaged endothelial tissues of patients with extrahepatic disease. Am J Gastroenterol. 2005, 100: 972-976. 10.1111/j.1572-0241.2005.41308.x.CrossRefPubMed Mason A, Theal J, Bain V, Adams E, Perrillo R: Hepatitis B virus replication in damaged endothelial tissues of patients with extrahepatic disease. Am J Gastroenterol. 2005, 100: 972-976. 10.1111/j.1572-0241.2005.41308.x.CrossRefPubMed
8.
Zurück zum Zitat Inman RD: Rheumatic manifestations of hepatitis B virus infection. Semin Arthritis Rheum. 1982, 11: 406-420. 10.1016/0049-0172(82)90028-2.CrossRefPubMed Inman RD: Rheumatic manifestations of hepatitis B virus infection. Semin Arthritis Rheum. 1982, 11: 406-420. 10.1016/0049-0172(82)90028-2.CrossRefPubMed
9.
Zurück zum Zitat Guillevin L, Mahr A, Callard P, Godmer P, Pagnoux C, Leray E, Cohen P: Hepatitis B virus-associated polyarteritis nodosa: clinical characteristics, outcome, and impact of treatment in 115 patients. Medicine (Baltimore). 2005, 84: 313-322. 10.1097/01.md.0000180792.80212.5e.CrossRef Guillevin L, Mahr A, Callard P, Godmer P, Pagnoux C, Leray E, Cohen P: Hepatitis B virus-associated polyarteritis nodosa: clinical characteristics, outcome, and impact of treatment in 115 patients. Medicine (Baltimore). 2005, 84: 313-322. 10.1097/01.md.0000180792.80212.5e.CrossRef
10.
Zurück zum Zitat Lauer GM, Walker BD: Hepatitis C virus infection. N Engl J Med. 2001, 345: 41-52. 10.1056/NEJM200107053450107.CrossRefPubMed Lauer GM, Walker BD: Hepatitis C virus infection. N Engl J Med. 2001, 345: 41-52. 10.1056/NEJM200107053450107.CrossRefPubMed
11.
Zurück zum Zitat Strader DB, Wright T, Thomas DL, Seeff LB: Diagnosis, management, and treatment of hepatitis C. Hepatology. 2004, 39: 1147-1171. 10.1002/hep.20119.CrossRefPubMed Strader DB, Wright T, Thomas DL, Seeff LB: Diagnosis, management, and treatment of hepatitis C. Hepatology. 2004, 39: 1147-1171. 10.1002/hep.20119.CrossRefPubMed
12.
Zurück zum Zitat Vassilopoulos D, Calabrese LH: Rheumatic manifestations of hepatitis C infection. Curr Rheumatol Rep. 2003, 5: 200-204. 10.1007/s11926-003-0067-8.CrossRefPubMed Vassilopoulos D, Calabrese LH: Rheumatic manifestations of hepatitis C infection. Curr Rheumatol Rep. 2003, 5: 200-204. 10.1007/s11926-003-0067-8.CrossRefPubMed
13.
Zurück zum Zitat Vassilopoulos D, Calabrese LH: Risks of immunosuppressive therapies including biologic agents in patients with rheumatic diseases and co-existing chronic viral infections. Curr Opin Rheumatol. 2007, 19: 619-625. 10.1097/BOR.0b013e3282f05b63.CrossRefPubMed Vassilopoulos D, Calabrese LH: Risks of immunosuppressive therapies including biologic agents in patients with rheumatic diseases and co-existing chronic viral infections. Curr Opin Rheumatol. 2007, 19: 619-625. 10.1097/BOR.0b013e3282f05b63.CrossRefPubMed
14.
Zurück zum Zitat Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, Paulus HE, Mudano A, Pisu M, Elkins-Melton M, Outman R, Allison JJ, Almazor MS, Bridges SL, Chatham WW, Hochberg M, MacLean C, Mikuls T, Moreland LW, O'Dell J, Turkiewicz AM, Furst DE: American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008, 59: 762-784. 10.1002/art.23721.CrossRefPubMed Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, Paulus HE, Mudano A, Pisu M, Elkins-Melton M, Outman R, Allison JJ, Almazor MS, Bridges SL, Chatham WW, Hochberg M, MacLean C, Mikuls T, Moreland LW, O'Dell J, Turkiewicz AM, Furst DE: American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008, 59: 762-784. 10.1002/art.23721.CrossRefPubMed
15.
Zurück zum Zitat Zein NN: Etanercept as an adjuvant to interferon and ribavirin in treatment-naive patients with chronic hepatitis C virus infection: a phase 2 randomized, double-blind, placebo-controlled study. J Hepatol. 2005, 42: 315-322. 10.1016/j.jhep.2004.11.025.CrossRefPubMed Zein NN: Etanercept as an adjuvant to interferon and ribavirin in treatment-naive patients with chronic hepatitis C virus infection: a phase 2 randomized, double-blind, placebo-controlled study. J Hepatol. 2005, 42: 315-322. 10.1016/j.jhep.2004.11.025.CrossRefPubMed
16.
Zurück zum Zitat Ferri C, Sebastiani M, Giuggioli D, Cazzato M, Longombardo G, Antonelli A, Puccini R, Michelassi C, Zignego AL: Mixed cryoglobulinemia: demographic, clinical, and serologic features and survival in 231 patients. Semin Arthritis Rheum. 2004, 33: 355-374. 10.1016/j.semarthrit.2003.10.001.CrossRefPubMed Ferri C, Sebastiani M, Giuggioli D, Cazzato M, Longombardo G, Antonelli A, Puccini R, Michelassi C, Zignego AL: Mixed cryoglobulinemia: demographic, clinical, and serologic features and survival in 231 patients. Semin Arthritis Rheum. 2004, 33: 355-374. 10.1016/j.semarthrit.2003.10.001.CrossRefPubMed
17.
Zurück zum Zitat Dore MP, Fattovich G, Sepulveda AR, Realdi G: Cryoglobulinemia related to hepatitis C virus infection. Dig Dis Sci. 2007, 52: 897-907. 10.1007/s10620-006-9510-9.CrossRefPubMed Dore MP, Fattovich G, Sepulveda AR, Realdi G: Cryoglobulinemia related to hepatitis C virus infection. Dig Dis Sci. 2007, 52: 897-907. 10.1007/s10620-006-9510-9.CrossRefPubMed
18.
Zurück zum Zitat Sansonno D, Dammacco F: Hepatitis C virus, cryoglobulinaemia, and vasculitis: immune complex relations. Lancet Infect Dis. 2005, 5: 227-236. 10.1016/S1473-3099(05)70053-0.CrossRefPubMed Sansonno D, Dammacco F: Hepatitis C virus, cryoglobulinaemia, and vasculitis: immune complex relations. Lancet Infect Dis. 2005, 5: 227-236. 10.1016/S1473-3099(05)70053-0.CrossRefPubMed
19.
Zurück zum Zitat Vassilopoulos D, Calabrese LH: Hepatitis C virus infection and vasculitis. Implications of antiviral and immunosuppressive therapies. Arthritis Rheum. 2002, 46: 585-597. 10.1002/art.10107.CrossRefPubMed Vassilopoulos D, Calabrese LH: Hepatitis C virus infection and vasculitis. Implications of antiviral and immunosuppressive therapies. Arthritis Rheum. 2002, 46: 585-597. 10.1002/art.10107.CrossRefPubMed
20.
Zurück zum Zitat Saadoun D, Resche-Rigon M, Sene D, Perard L, Piette JC, Cacoub P: Rituximab combined with Peg-Interferon-Ribavirin in refractory HCV-associated cryoglobulinemia vasculitis. Ann Rheum Dis. 2008, Jan 4 Saadoun D, Resche-Rigon M, Sene D, Perard L, Piette JC, Cacoub P: Rituximab combined with Peg-Interferon-Ribavirin in refractory HCV-associated cryoglobulinemia vasculitis. Ann Rheum Dis. 2008, Jan 4
21.
Zurück zum Zitat Rosner I, Rozenbaum M, Toubi E, Kessel A, Naschitz JE, Zuckerman E: The case for hepatitis C arthritis. Semin Arthritis Rheum. 2004, 33: 375-387. 10.1016/j.semarthrit.2003.12.006.CrossRefPubMed Rosner I, Rozenbaum M, Toubi E, Kessel A, Naschitz JE, Zuckerman E: The case for hepatitis C arthritis. Semin Arthritis Rheum. 2004, 33: 375-387. 10.1016/j.semarthrit.2003.12.006.CrossRefPubMed
22.
23.
Zurück zum Zitat Soderlund M, von Essen R, Haapasaari J, Kiistala U, Kiviluoto O, Hedman K: Persistence of parvovirus B19 DNA in synovial membranes of young patients with and without chronic arthropathy. Lancet. 1997, 349: 1063-1065. 10.1016/S0140-6736(96)09110-6.CrossRefPubMed Soderlund M, von Essen R, Haapasaari J, Kiistala U, Kiviluoto O, Hedman K: Persistence of parvovirus B19 DNA in synovial membranes of young patients with and without chronic arthropathy. Lancet. 1997, 349: 1063-1065. 10.1016/S0140-6736(96)09110-6.CrossRefPubMed
24.
Zurück zum Zitat Calabrese LH: Rheumatic manifestations of HIV infection. Cleve Clin J Med. 1993, 60: 484-485.CrossRefPubMed Calabrese LH: Rheumatic manifestations of HIV infection. Cleve Clin J Med. 1993, 60: 484-485.CrossRefPubMed
25.
Zurück zum Zitat Reveille JD, Williams FM: Infection and musculoskeletal conditions: rheumatologic complications of HIV infection. Best Pract Res Clin Rheumatol. 2006, 20: 1159-1179. 10.1016/j.berh.2006.08.015.CrossRefPubMed Reveille JD, Williams FM: Infection and musculoskeletal conditions: rheumatologic complications of HIV infection. Best Pract Res Clin Rheumatol. 2006, 20: 1159-1179. 10.1016/j.berh.2006.08.015.CrossRefPubMed
26.
Zurück zum Zitat Calabrese LH, Kirchner E, Shrestha R: Rheumatic complications of human immunodeficiency virus infection in the era of highly active antiretroviral therapy: emergence of a new syndrome of immune reconstitution and changing patterns of disease. Semin Arthritis Rheum. 2005, 35: 166-174. 10.1016/j.semarthrit.2005.03.007.CrossRefPubMed Calabrese LH, Kirchner E, Shrestha R: Rheumatic complications of human immunodeficiency virus infection in the era of highly active antiretroviral therapy: emergence of a new syndrome of immune reconstitution and changing patterns of disease. Semin Arthritis Rheum. 2005, 35: 166-174. 10.1016/j.semarthrit.2005.03.007.CrossRefPubMed
27.
Zurück zum Zitat Calabrese LH: Emerging viral infections and arthritis: the role of the rheumatologist. Nat Clin Pract Rheumatol. 2008, 4: 2-3. 10.1038/ncprheum0679.CrossRefPubMed Calabrese LH: Emerging viral infections and arthritis: the role of the rheumatologist. Nat Clin Pract Rheumatol. 2008, 4: 2-3. 10.1038/ncprheum0679.CrossRefPubMed
28.
Zurück zum Zitat Laine M, Luukkainen R, Toivanen A: Sindbis viruses and other alphaviruses as cause of human arthritic disease. J Intern Med. 2004, 256: 457-471. 10.1111/j.1365-2796.2004.01413.x.CrossRefPubMed Laine M, Luukkainen R, Toivanen A: Sindbis viruses and other alphaviruses as cause of human arthritic disease. J Intern Med. 2004, 256: 457-471. 10.1111/j.1365-2796.2004.01413.x.CrossRefPubMed
29.
Zurück zum Zitat Suhrbier A, La Linn M: Clinical and pathologic aspects of arthritis due to Ross River virus and other alphaviruses. Curr Opin Rheumatol. 2004, 16: 374-379. 10.1097/01.bor.0000130537.76808.26.CrossRefPubMed Suhrbier A, La Linn M: Clinical and pathologic aspects of arthritis due to Ross River virus and other alphaviruses. Curr Opin Rheumatol. 2004, 16: 374-379. 10.1097/01.bor.0000130537.76808.26.CrossRefPubMed
30.
Zurück zum Zitat Simon F, Parola P, Grandadam M, Fourcade S, Oliver M, Brouqui P, Hance P, Kraemer P, Ali MA, de Lamballerie X, Charrel R, Tolou H: Chikungunya infection: an emerging rheumatism among travelers returned from Indian Ocean islands. Report of 47 cases. Medicine (Baltimore). 2007, 86: 123-137. 10.1097/MD/0b013e31806010a5.CrossRef Simon F, Parola P, Grandadam M, Fourcade S, Oliver M, Brouqui P, Hance P, Kraemer P, Ali MA, de Lamballerie X, Charrel R, Tolou H: Chikungunya infection: an emerging rheumatism among travelers returned from Indian Ocean islands. Report of 47 cases. Medicine (Baltimore). 2007, 86: 123-137. 10.1097/MD/0b013e31806010a5.CrossRef
31.
Zurück zum Zitat Charrel RN, de Lamballerie X, Raoult D: Chikungunya outbreaks – the globalization of vectorborne diseases. N Engl J Med. 2007, 356: 769-771. 10.1056/NEJMp078013.CrossRefPubMed Charrel RN, de Lamballerie X, Raoult D: Chikungunya outbreaks – the globalization of vectorborne diseases. N Engl J Med. 2007, 356: 769-771. 10.1056/NEJMp078013.CrossRefPubMed
32.
Zurück zum Zitat Angelini R, Finarelli AC, Angelini P, Po C, Petropulacos K, Macini P, Fiorentini C, Fortuna C, Venturi G, Romi R, Majori G, Nicoletti L, Rezza G, Cassone A: An outbreak of chikungunya fever in the province of Ravenna, Italy. Euro Surveill. 2007, 12: E070906-PubMed Angelini R, Finarelli AC, Angelini P, Po C, Petropulacos K, Macini P, Fiorentini C, Fortuna C, Venturi G, Romi R, Majori G, Nicoletti L, Rezza G, Cassone A: An outbreak of chikungunya fever in the province of Ravenna, Italy. Euro Surveill. 2007, 12: E070906-PubMed
33.
Zurück zum Zitat Rezza G, Nicoletti L, Angelini R, Romi R, Finarelli AC, Panning M, Cordioli P, Fortuna C, Boros S, Magurano F, Silvi G, Angelini P, Dottori M, Ciufolini MG, Majori GC, Cassone A: Infection with chikungunya virus in Italy: an outbreak in a temperate region. Lancet. 2007, 370: 1840-1846. 10.1016/S0140-6736(07)61779-6.CrossRefPubMed Rezza G, Nicoletti L, Angelini R, Romi R, Finarelli AC, Panning M, Cordioli P, Fortuna C, Boros S, Magurano F, Silvi G, Angelini P, Dottori M, Ciufolini MG, Majori GC, Cassone A: Infection with chikungunya virus in Italy: an outbreak in a temperate region. Lancet. 2007, 370: 1840-1846. 10.1016/S0140-6736(07)61779-6.CrossRefPubMed
34.
Zurück zum Zitat Update: chikungunya fever diagnosed among international travelers – United States, 2006. MMWR Morb Mortal Wkly Rep. 2007, 56: 276-277. Update: chikungunya fever diagnosed among international travelers – United States, 2006. MMWR Morb Mortal Wkly Rep. 2007, 56: 276-277.
36.
Zurück zum Zitat Masuko-Hongo K, Kato T, Nishioka K: Virus-associated arthritis. Best Pract Res Clin Rheumatol. 2003, 17: 309-318. 10.1016/S1521-6942(03)00004-4.CrossRefPubMed Masuko-Hongo K, Kato T, Nishioka K: Virus-associated arthritis. Best Pract Res Clin Rheumatol. 2003, 17: 309-318. 10.1016/S1521-6942(03)00004-4.CrossRefPubMed
37.
Zurück zum Zitat Smith CA, Petty RE, Tingle AJ: Rubella virus and arthritis. Rheum Dis Clin North Am. 1987, 13: 265-274.PubMed Smith CA, Petty RE, Tingle AJ: Rubella virus and arthritis. Rheum Dis Clin North Am. 1987, 13: 265-274.PubMed
38.
Zurück zum Zitat Ray CG, Gall EP, Minnich LL, Roediger J, De Benedetti C, Corrigan JJ: Acute polyarthritis associated with active Epstein-Barr virus infection. JAMA. 1982, 248: 2990-2993. 10.1001/jama.248.22.2990.CrossRefPubMed Ray CG, Gall EP, Minnich LL, Roediger J, De Benedetti C, Corrigan JJ: Acute polyarthritis associated with active Epstein-Barr virus infection. JAMA. 1982, 248: 2990-2993. 10.1001/jama.248.22.2990.CrossRefPubMed
39.
Zurück zum Zitat Hurst NP, Martynoga AG, Nuki G, Sewell JR, Mitchell A, Hughes GR: Coxsackie B infection and arthritis. Br Med J (Clin Res Ed). 1983, 286: 605-CrossRef Hurst NP, Martynoga AG, Nuki G, Sewell JR, Mitchell A, Hughes GR: Coxsackie B infection and arthritis. Br Med J (Clin Res Ed). 1983, 286: 605-CrossRef
40.
41.
Zurück zum Zitat Zerrak A, Bour JB, Tavernier C, Dougados M, Maillefert JF: Usefulness of routine hepatitis C virus, hepatitis B virus, and parvovirus B19 serology in the diagnosis of recent-onset inflammatory arthritides. Arthritis Rheum. 2005, 53: 477-478. 10.1002/art.21182.CrossRefPubMed Zerrak A, Bour JB, Tavernier C, Dougados M, Maillefert JF: Usefulness of routine hepatitis C virus, hepatitis B virus, and parvovirus B19 serology in the diagnosis of recent-onset inflammatory arthritides. Arthritis Rheum. 2005, 53: 477-478. 10.1002/art.21182.CrossRefPubMed
42.
Zurück zum Zitat Hannu T, Hedman K, Hedman L, Leirisalo-Repo M: Frequency of recent parvovirus infection in patients examined for acute reactive arthritis. A study with combinatorial parvovirus sero-diagnostics. Clin Exp Rheumatol. 2007, 25: 297-300.PubMed Hannu T, Hedman K, Hedman L, Leirisalo-Repo M: Frequency of recent parvovirus infection in patients examined for acute reactive arthritis. A study with combinatorial parvovirus sero-diagnostics. Clin Exp Rheumatol. 2007, 25: 297-300.PubMed
Metadaten
Titel
Virally associated arthritis 2008: clinical, epidemiologic, and pathophysiologic considerations
verfasst von
Dimitrios Vassilopoulos
Leonard H Calabrese
Publikationsdatum
01.10.2008
Verlag
BioMed Central
Erschienen in
Arthritis Research & Therapy / Ausgabe 5/2008
Elektronische ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2480

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