Arthralgia is defined as pain in one or more joints, with no inflammation. There are many causes of arthralgia including injuries, infections, arthritis, and other disorders [1]. Many acute and chronic viral infections, such as Chikungunya and hepatitis B, are associated with polyarthralgias [2, 3]. Many studies reported arthralgia to be commonly associated with infection by hepatitis C virus [4,5,6,7,8].

Hepatitis C virus (HCV) is an enveloped, positive-sense single-stranded RNA virus belonging to the Flaviviridae family. Currently, HCV is classified into eight genotypes [9]. The global prevalence of HCV was estimated at 2.5%, ranging from 1.3% in Americas to 2.9% in Africa with significant morbidity and mortality [10]. HCV is a blood-borne virus that can be transmitted from person to person via exposure to contaminated blood such as through sharing drug-injection equipment, infants born to infected mothers, blood transfusion, sharing personal items (e.g., glucose monitors, razors, nail clippers, and toothbrushes). Though sexual transmission is uncommon, it has been reported more frequently among homosexual men [11]. In Yemen, the seroprevalence of HCV among general population was estimated to be 1.3%. However, seroprevalence among high risk groups was found to be: 1.5% in healthcare workers, 8.5% in pregnant women, and 40-62.7% in hemodialysis patients [12,13,14,15].

Less than 15% of people infected with HCV develop acute hepatitis while the remainder progress to chronic hepatitis. Chronic hepatitis C (CHC) can cause severe complications such as liver cirrhosis, hepatocellular carcinoma, and end-stage liver disease over the subsequent 30 years. Liver cirrhosis due to viral hepatitis C is the leading cause of liver transplantation in Europe [16,17,18]. HCV is not only associated with liver disease but is also frequently associated with multiple extrahepatic manifestations such as arthralgia, myalgia, arthritis, vasculitis, nephropathy, Sicca syndrome, and non-Hodgkin B-cell lymphoma [19, 20].

Arthralgia is the most common extrahepatic manifestation of CHC. In a study conducted in Brazil, arthralgia was found in 90.6% of patients infected with HCV [3]. Arthralgia is bilaterally symmetrical and involves more often the fingers, knee, and back. Arthralgia associated with CHC may mimic symptoms of rheumatoid arthritis. However, HCV-infected patients do not develop anticyclic citrullinated peptide antibodies (anti-CCP) which is helpful to distinguish between the two diseases [7].

Screening patients with arthralgia for HCV may be useful for HCV diagnosis and early treatment before progression to liver cirrhosis. Therefore, this study aimed to determine the prevalence of HCV among patients with chronic unexplained arthralgia.