Hepatitis C-associated osteosclerosis (HCAO) remains a rare condition despite the growing prevalence of hepatitis C virus (HCV) infection worldwide. Since the first case reported in 1992, this is the twenty-second case described. Patients with HCAO present with severe bone pain and elevated serum levels of bone markers, especially alkaline phosphatase (ALP), with increased bone density. We report here the case of a 59-year-old man with generalized bone pain and diagnosis of HCV infection. Biochemical tests showed elevated bone turnover markers, specifically, ALP, carboxy-terminal collagen crosslinks and osteocalcin. Imaging studies revealed generalized bone sclerosis. Bone mineral density was elevated in all validated sites. His clinical symptoms and bone-related findings were attributed to HCAO. He was sequentially treated with cholecalciferol, prednisone, sofosbuvir associated with daclatasvir and ibandronate, and progressed with undetectable viral load after HCV treatment, normalization of ALP levels after introduction of ibandronate, and pain improvement 1 year after discontinuation of the bisphosphonate. Bone pain complaints must be investigated in patients with HCV. HCAO is a differential diagnosis of increased bone mass.

尽管丙型肝炎病毒 (HCV) 感染在世界范围内日益流行，但丙型肝炎相关的骨硬化症 (HCAO) 仍然是一种罕见的疾病。自 1992 年报告第一例病例以来，这是所描述的第 22 例病例。HCAO 患者出现严重的骨痛和骨标志物血清水平升高，尤其是碱性磷酸酶 (ALP)，骨密度增加。我们在此报告一例 59 岁男性全身骨痛并诊断为 HCV 感染的病例。生化测试显示骨转换标志物升高，特别是 ALP、羧基末端胶原交联和骨钙素。影像学研究显示全身性骨硬化。所有验证部位的骨矿物质密度均升高。他的临床症状和骨骼相关发现归因于 HCAO。他依次接受了胆钙化醇治疗，强的松、索非布韦与 daclatasvir 和伊班膦酸盐相关，HCV 治疗后病毒载量无法检测，伊班膦酸盐治疗后 ALP 水平恢复正常，双膦酸盐停用 1 年后疼痛改善。必须对 HCV 患者的骨痛主诉进行调查。HCAO 是骨量增加的鉴别诊断。