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Patients with rheumatoid arthritis (RA) and hepatitis C present a diagnostic dilemma due to the viral induced immunogenistic response with subsequent biomarkers and an associated arthropathy that is difficult to distinguish from RA. They also present as a treatment dilemma due to restrictions in the use of disease modifying anti-rheumatic drugs that are standards of care such as methotrexate and leflunomide. Unfortunately they are often excluded from clinical trials in our newer RA therapeutics.
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