Anti- cyclic citrullinated peptide antibodies in tuberculosis and human immunodeficiency virus

Background: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been considered very specific for rheumatoid arthritis (RA). Some studies have shown that these antibodies can be positive in infectious diseases like tuberculosis, human immunodeficiency virus infection, etc.Methods: Eighty patients of tuberculosis both pulmonary and extra-pulmonary tuberculosis and thirty patients of human immunodeficiency virus were enrolled in this study from inpatient and outpatient departments from September 2018 to August 2019. Anti-CCP antibody test was done in all the patient by enzyme linked immunosorbent assay.Results: Fifty-three patients were of pulmonary tuberculosis, 27 patients were extra-pulmonary tuberculosis and 30 patients were human immunodeficiency virus infection. Of the 53 cases of pulmonary tuberculosis, 21 (39.6%) cases were positive for anti-CCP antibodies and 32 (60.4%) cases were negative for the same. Of the 27 cases of extra-pulmonary tuberculosis, 3(11.1%) cases were positive for anti-CCP antibodies and 24 (88.9%) cases were negative. Of the 53 patients of pulmonary tuberculosis, 16 were sputum positive and 37 were sputum negative. Of those withsputum positive 9 (56.2%) cases were positive for anti-CCP antibodies and those with sputum negative, 12 (32.4%) cases were positive for anti-CCP antibodies. Of the 30 cases of human immunodeficiency virus, 5 (16.7%) cases were positive for anti-CCP antibodies and 25 (83.3%) cases were negative.Conclusions: Anti-CCP can be positive in cases of infectious diseases like tuberculosis and human immunodeficiency virus. Positivity of anti-CCP antibodies for tuberculosis is more for pulmonary (more for sputum-positive than sputum-negative) than extra-pulmonary tuberculosis. Anti-CCP, thus is not very specific for rheumatoid arthritis.