Urticaria is a common disorder that affects up to 20% of the population at some point during their lifetime. Aggravating factors include drugs, foods, additives, connective tissue disorders and infections. It is well established that Hepatitis B virus causes urticaria. Whether Hepatitis C infection causes urticaria or not is still debated with reports both in favor of and against this. Kanazawa and colleagues reported a positive relationship between hepatitis C and urticaria. Subsequent studies however did not confirm this.

A 49y old man presented with a history of recurrent urticaria of several months duration. The history was unremarkable apart from promiscuity. Routine screening investigations were negative apart from a raised ALT. In view this, hepatitis serology was requested. Hepatitis C antibody was reported to be positive by both ELISA & MEIA. Results of ELISA for Hepatitis B were negative.

There does not appear to be any clear-cut evidence to affirm or refute a direct link between chronic urticaria and HCV infection in the literature. We suggest that HCV status should be checked in patients presenting with urticaria in areas with a high prevalence. It may not be cost effective to routinely screen for HCV where the prevalence is low, but should be considered where the history or laboratory tests suggest this possibility.

We conclude that HCV infection may have caused urticaria in this patient. Further studies are needed to establish an association, aetiopathogenic role and cost implications of screening or therapy of HCV in chronic urticaria.