Systemic Lupus Erythematosus

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•hcspFACTsheet• Hepatitis C Support Project •
a series of fact sheets written
the largest studies on lupus and HCV was performed by
Manuel Ramos-Casals and colleagues1 which evaluated
by experts in the field of liver
the relationship between lupus and HCV among 134
patients with lupus (121 women and 13 men). In this
study it was reported that HCV antibodies were present
and confirmed in 11% of the study participants. The
HCV – Extrahepatic Manifestations: authors also commented that some of the HCV-related
lupus appeared to produce or mimic the symptoms of
Systemic Lupus
lupus which would result in a lower number of people
in the trial who had ‘true’ lupus. It is important to
know that this study looked at the prevalence of HCV
in a group of people with lupus, but it was not a study
that looked at the prevalence of lupus in the hepatitis
Alan Franciscus, Editor-in-Chief
C population. We do not know the percentage or how
many people with hepatitis C also have lupus but it is
SyStemic lupuS erythematoSuS (Sle)
believed to be very low.
is a disease that can cause inflammation and damage
to various parts of the body. Lupus can affect any
Symptoms and Diagnosis
area of the body, but it most often affects the joints,
skin, kidneys, heart, lungs, blood, or brain. Lupus is
The diagnosis of lupus is often difficult because the
an autoimmune disease – this is when a person’s
symptoms are similar to other diseases or conditions.
immune system produces antibodies against normal
The most common symptoms of lupus include joint
cel s and organs. It is estimated that between 1.5 and
pain, frequent unexplained fever, swollen joints, fatigue
2 mil ion Americans have been diagnosed with lupus
(moderate to severe), skin rashes, chest pain (especially
and there are about 16,000 Americans who develop
on deep breathing), rash across the cheek and nose
lupus each year. Lupus more commonly strikes woman
(resembles the shape of a butterfly), sensitivity to light
than men – about 90% of al lupus cases are among
or the sun, hair loss, abnormal blood clotting, Raynaud’s
women. The majority of women are diagnosed between
syndrome, seizures and/or mouth or nose ulcers, and
the ages of 15 and 45. Lupus is more than two to
anemia. At this time there is no single laboratory test
three times as common in people of color – African
to diagnose lupus.
Americans, Hispanics, Asians, and Native Americans
– than in Caucasians.
The American Col ege of Rheumatology (ACR) issued a
list of 11 criteria or symptoms that are used to diagnose
For most people with lupus it is a mild condition that
lupus including:
usually only affects a few organs, but in others it can
1. Rash on cheeks (mylar rash)
be a serious, debilitating and even life-threatening
2. Red, scaly skin patches (discoid lupus)
3. Rashes due to exposure to light (photosensitiv-
The exact cause of lupus is not known, but environ-
4. Oral ulcers
mental, genetic, other conditions and diseases (such as
5. Arthritis – nonerosive of two or more peripheral
HCV) may act as a trigger. There is a limited amount of
joints, with tenderness, swelling or effusion (af-
information about the HCV connection to lupus. One of
fecting the junction of the joint)
HCSP • VERSION 1.2 • February 2009

6. Kidney disorders
anti-inflammatory drugs (NSAIDs), acetaminophen,
7. Seizures or psychosis
corticosteroids, immunomodulating drugs, and anti-
8. Inflammation of the lungs or heart
9. Low red or white blood cells (anemia or neutro-
• There is much research that is looking at what
10. Anti-nuclear antibody positive – a measure of
causes lupus and what drugs can be used to treat
autoimmune disease
it. For more information on clinical trials for lupus
11. Positive test results for a certain immunologic
go to
A diagnosis is usually made when a person has 4 or
more of these symptoms and/or blood test abnormali-
Ramos-Casals M, Font J, Garcia-Carrasco M, Cervera,
R, Jimenez, S, Trejo, O, De La Red, G, Sanchez-Tapias,
Disease Progression
J, and Ingelmo M. Hepatitis C Virus infection mimicking
systemic lupus erythematosus. Arthritis Rheum. 2000;
There is no cure (at this time) for lupus, but the prog-
nosis for most people with lupus is good. Some people
will develop serious or life-threatening illness, but the
vast majority of people with lupus can expect to live a
normal lifespan. As with any condition or disease, it is
• Lupus Foundation of America INC – www.lupus.
always important to become as educated as possible
and advocate for your medical care. There are some
• A m e r i c a n C o l l e g e o f R h e u m a t o l o g y -
organizations that help people with lupus and it is a
good idea to find a support group in your area so that
you can connect to and get support from others who
have the same condition.
For more information about hepatitis c, hepatitis B and
hcV coinfections, please visit

There are many strategies to treat or manage lupus.
The most important strategy is to work closely with a
A publication of the Hepatitis C Support Project
knowledgeable medical team. The medical specialist
executive Director
The information in this fact sheet is
who manages and treats lupus is rheumatologist – a
editor-in-chief, hcSp publications designed to help you understand and
doctor that specializes in treating diseases that affect
Alan Franciscus
manage HCV and is not intended as
the joints and muscles. It is also important that a per-
medical advice. All persons with HCV
should consult a medical practitioner for
son with lupus learn to recognize when an increase in
Paula Fener
diagnosis and treatment of HCV.
symptoms is starting (‘flare-up’) and what triggers it to

C.D. Mazoff, PhD
This information is provided by the
avoid anything that can lead to a ‘flare-up.’ In general
Hepatitis C Support Project • a nonprofit
contact information:
it is recommended that people with lupus avoid exces-
organization for HCV education, support
Hepatitis C Support Project
and advocacy• © 2009 Hepatitis C
sive alcohol consumption, smoking, and overexposure
PO Box 427037
San Francisco, CA 94142-7037
Support Project • Reprint permission is
to the sun.
granted and encouraged with credit to
[email protected]
the Hepatitis C Support Project.
There are many medications that can help to allevi-
ate the symptoms of lupus including non-steroidal
HCSP • VERSION 1.2 • February 2009