Clinical

HCV and HIV may trigger antiphospholipid syndrome

Last Updated: 2004-04-16 12:25:03 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Hepatitis C virus (HCV) and HIV infection may be involved in certain, albeit rare, cases of the autoimmune disorder antiphospholipid syndrome, Spanish and Mexican researchers report in the April 1st issue of Clinical Infectious Diseases. However, this disorder is likely to become more common.

As lead investigator Dr. Manuel Ramos-Casals told Reuters Health, the data "suggest that antiphospholipid syndrome is infrequently observed in patients with chronic viral diseases such as HCV or HIV infection, although the progressive use of antiviral therapies will lead to a probable increase in the number of patients presenting with autoimmune or rheumatic features."

Dr. Ramos-Casals of Hospital Clinic, Barcelona and colleagues, using data from Spain and Latin America, identified 82 cases of antiphospholipid syndrome in patients with viral infection. Of these, 45 had chronic HCV, 32 had HIV and the remaining 5 had HIV-HCV coinfection.

Among the main clinical features were avascular bone necrosis in 20 patients, peripheral thrombosis in 17, thrombocytopenia in 15, neurological features in 13 and cutaneous manifestations in 8.

In particular, the main features in HCV patients were intra-abdominal thrombosis and myocardial infarction. In HIV patients, these were avascular bone and cutaneous necrosis.

"These viruses may play an etiopathogenic role in certain patients with antiphospholipid syndrome," Dr. Ramos-Casals continued. He and his colleagues conclude that the viruses "might act in some patients as chronic triggering agents that induce a heterogeneous, atypical presentation."

Clin Infect Dis 2004;38:1009-1016.