HCV symptoms

[DragonSlayer45]

I have not posted for a while in the forum but have followed the forum off and on for a couple of years.

I have a question to others about symptoms I experience, and was curious as to why. For a little background about me:

I am a geno 1a, stage 2 grade 2, with a high viral load (>5 million at every test). I have had HCV  for maybe 25 + years and was diagnosed in 1994 when donating blood at a Red Cross blood drive at work. I have never had elevated enzymes at any blood test taken.  I had my 2nd biopsy this past year and it showed the exact same results as the previous one from 5 years earlier, which is good news because I am not progressing. I am treatment naive, although I came really close to going on the NM283 trial with peg and riba last year before changing my mind. I was never interested in the current treatments available. I do not like the odds for myself or care for the sides it causes.

I have been noticing changes in myself and my symptoms that bother me and baffle me a little. My brian fog seems to be a little worse and I fumble for words more, have more difficulty retaining information, I am definitely more irritable, right side hurts, joints are bothering me (knees especially). Doctor agrees it is the hep C talking to me.

My question is if my tests are always the same with normal liver functions and my biopsies are not showing any progression in liver damage, then why do I feel worse?
All I know is that at 46 years of age a man should not feel this way. I have always been a "glass is half full guy" but it seems to be harder and harder to do that anymore. I always walk around sort of pretending I am healthy but more and more it seems to tap me on the shoulder and say "Hey remember me I'm still here".

I exercise, all low impact (elliptical, rowing machine). I eat a healthy diet with lots of veggies, fruit, and whole grain. I do not drink soda or consume sugar (or other sugar products that mascarade as something else).

So why do I feel like S&!%?

[jmjm530]

Dragon: I have been noticing changes in myself and my symptoms that bother me and baffle me a little. My brian fog seems to be a little worse and I fumble for words more, have more difficulty retaining information, I am definitely more irritable, right side hurts, joints are bothering me (knees especially). Doctor agrees it is the hep C talking to me.
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I don't think anyone can tell whether the symptons you describe are from Hep C, something(s) else, or just part of the aging process -- or perhaps a combination.

At age 45, I also had Hep C for around 25 years, and also was probably around stage 2 then, although I'd have to check my biopsy reports on that.

Also, at age 45, I noticed some diminishing in cognitive/memory issues as well as more joint/muscular issues.

That said, many of my non-HCV contemporaries also noted these same issues, and that not a surprise, since that's about the age that the aging process becomes more noticeable in many of us.

Fast forward, I treated at age 58 -- I was around stage 3 then -- and am now SVR for a year and a half.  Because I am SVR, hopefully my fibrosis has regressed and my chances of liver cancer diminished. Treatment was the right decision for me at the time I made it.

That said, I can't say my energy levels are better after treatment than before. Nor are the cognitive issues or joint and muscular pain. If anything I don't feel as well after treatment as I did before. Maybe it's the interferon -- and I'm convinced that's a large part of it -- but it could also be the aging process as well.

Not sure where I'm going here, except to say that it's not always easy to tell what symptons are caused by Hepatitis C and what aren't. Also very difficult to predict whether treatment will cause many of these symptons to get better, stay the same, or get worse. All three scenarios have been reported here anecdotally.

Wish I could give you the answer to why you "feel like S&!%?", but I don't think there is an easy answer. But since you still don't have significant liver damage, one option -- besides treating -- is to up your lifestyle IQ. Eat smarter. Exercise smarter. Handle stress smarter.

All the best,

-- Jim

[JRenquist]

Are you taking any suplements - like milk thistle or Vitamin E?  I started feeling a little bit better after I used them for a while.

[Myown]

DS said: have been noticing changes in myself and my symptoms that bother me and baffle me a little. My brian fog seems to be a little worse and I fumble for words more, have more difficulty retaining information....
My question is if my tests are always the same with normal liver functions and my biopsies are not showing any progression in liver damage, then why do I feel worse?
All I know is that at 46 years of age a man should not feel this way. I have always been a "glass is half full guy" but it seems to be harder and harder to do that anymore. I always walk around sort of pretending I am healthy but more and more it seems to tap me on the shoulder and say "Hey remember me I'm still here".

NATAP - DDW Liver Conference, San Diego, May 21-24 - Report 11

HCV and Brain Dysfunction

We know that HIV enters the brain shortly after a person is infected with HIV. It does appear as though individuals with HIV may experience symptoms related to this such as reduced alertness or a slower thinking capacity due to HIV. At both recent liver conferences--DDW and EASL--two different research groups reported research findings suggesting that HCV in individuals with less advanced disease (non-cirrhotics or mild fibrosis) affects the brain and reduces its functioning capacity. This suggests to me that a person with both HCV and HIV may be affected even more with regards to brain functioning. Over the years people with HIV have complained about experiencing fatigue and/or itching. We now know that many people with HIV also have HCV, and that HCV can cause itching and fatigue. The findings reported at DDW and EASL suggest that HCV related fatigue may be associated with the affect of HCV on the brain.

It's known that individuals with advanced cirrhosis can experience hepatic encephalopothy which can cause brain disorder, but it's important to bear in mind that the participants in the studies discussed below did not have such advanced HCV disease so the brain dysfunctioning found was not due to hepatic encephalopoathy.

At DDW, Ludwig Kramer and a research group from the University of Austria, reported that "cognitive processing was subclinically impaired in patients as compared to healthy subjects". They studied the impact of HCV infection on sensitive markers of cognitive brain function. Fifty-eight noncirrhotic patients with chronic HCV infection (age, 45±13 years, mean±SD) were studied by P300 event-related potentials (an objective measure of cognitive processing) and by the SF-36 questionnaire for assessment of health-related quality of life. Findings were compared to 58 matched healthy subjects. He found that P300 test results were imparied in patients with HCV compared to healthy volunteers, and conluded that patients with chronic HCV infection in the absence of cirrhosis exhibit a subclinical neurophysiological impairment. Cerebral function, however, seems to normalize with antiviral treatment. Although it was not apparent to me if normalization was tied with significant reductions in HCV viral levels, my feeling is that improvements in cerebral function can improve with HCV treatment despite no HCV viral level reductions. More detailed data and discussion are available below at the end of this report.

[Myown]

At EASL, DM Horton presented an oral talk on brain dysfunction in people with HCV for a UK research group from the Imperial College School of Medicine and St Mary's Hospital in London. First he reviewed two studies. He mentioned a UK study (Foster et al 1998) using the SF-36 questionaire, and reported people with HCV compared to normal controls scored worse in physical and social functioning, energy and fatigue, and other measures. These  results were independent of intravenous drug use. In a large US (Johnson et al 1998), 309 IVDUs both with or without HCV were tested for depression and those with HCV (57.2%) were found to have significantly more depressive symptomology than those who were negative to hepatitis (48.2%).

In an attempt to further define this neuropsychological syndrome, they administered a battery of neuropsychometric tests to 15 patients with histologically mild hepatitis C from liver biopsy. They tested for attention (included: simple reaction time, choice reaction time), working memory (numeric & spatial working memory), and secondary memory (delayed word recall). They found that patients with mild or minimal hepatis C from liver biopsy were slower in tests of working memory. He noted that although they were slow their accuracy on these tasks was preserved, and this has been described in chronic fatigue syndrome. There were no attention or secondary memory abnormalities.

In the view of these findings they asked themselves if HCV infects cells in the CNS (central nervous system), does this cause cerebral metabolite abnormalities, and is cerebral HCV infection the cause of the observed neuropsychological symptoms? They carried out a proton cerebral magnetic resonance spectroscopy study to determine if metabolite abnormalities exist in the brain of patients with hitologically mild hepatitis C. They randomly selected 30 patients with biopsy proven mild or minimal hepatitis due to HCV. As well, they studied 29 matched controls, and 12 eAG+ve patients with chronic HBV. No patient in the HBV or HCV groups had significant fibrosis or cirrhosis. The researchers reported seeing metabolic abnormalities in the testing in those with HCV compared to both normals (volunteers) and chronic HBV patients. There were no statistical differences between the normals and those with HBV. These abnormalities were not due to hepatic encephalopathy. They described the abnormalities as being similar to those abnormalities observed in HIV. Again, no patient in this study had significant fibrosis or cirrhosis. None of the study participants had used IV drugs in the 6 months preceding the study.  There was no statistical difference in the study results between those with or without prior drug use. Those with prior drug use had the same abnormalities as those who never used IV drugs. The researchers concluded that prior drug use did not affect the outcome of the study.

Is there direct infection by HCV of the CNS?

He presented a suggested potential model by which this could happen. Microglial cells in the brain turn over slowly and are replenished by circulating monocytes, possibly up to 30% in one year. Circulating monocytes are potentially infectable by HCV, and may carry the virus across the blood brain barrier into the brain and the microglial cells. Once in the cells they become activated and produce chemokines, cytokines, and neurosteroids which may mediate the neuropsychiatric symptoms described in this presentation. The question still remains--does HCV infect the microglial cells in the brain? The only way to answer this question is to conduct direct post mortem viralogic examination of brain tissue which is being currently undertaken at Imperial College School of Medicine in London.

He also sugested that of equal or possibly greater importance is the possibility that the  brain may act as a sancutary site for HCV allowing immune evasion and protection against antiviral therapy. He suggested that cessation of viral production from the liver may occur during phase 1 of viral decline after starting HCV therapy, but the slower viral decline during phase 2 may be due to a continued release of virus from the brain. He suggested that an alternative explanation for possible brain dysfunction seen with HCV could be that systemic cytokines cross the blood-brain barrier and may exert an effect. But he discounted this theory because in this study patients with HBV had normal spectroscopy. HCV antiviral therapy has been administered to the study patients and results are pending. In the study reported at DDW, and discussed above, the study authors reported therapy improved cerebral function, and they suggest their data may indicate a direct action of HCV infection on the brain.

DDW abstract:

[Myown]

COGNITIVE BRAIN FUNCTION IS SUBCLINICALLY IMPAIRED IN PATIENTS WITH CHRONIC HEPATITIS C - DOES HEPATITIS C AFFECT THE BRAIN?

Ludwig Kramer, Edith Bauer, Harald Hofer, Georg Funk, Petra Munda-Steindl, Christian Madl, Peter Ferenci, Dept of Medicine IV, Univ of Vienna, Vienna, Austria; Univ Hosp of Vienna, Vienna, Austria; Dept of Medicine IV, Vienna, Austria.

Fatigue and depression occur more frequently in chronic hepatitis C virus (HCV) infection than in other causes of chronic liver disease. However there is no correlation between severity of hepatitis and cerebral symptoms. It has been hypothesized that HCV exerted a direct effect on the brain. We studied the impact of HCV infection on sensitive markers of cognitive brain function. Fifty-eight noncirrhotic patients with chronic HCV infection (age, 45±13 years, mean±SD) were studied by P300 event-related potentials (an objective measure of cognitive processing) and by the SF-36 questionnaire for assessment of health-related quality of life. P300 latency is related to signal-processing speed; P300 amplitude reflects the amount of conscious attention paid to a stimulus. Findings were compared to 58 matched healthy subjects. We found that cognitive processing was subclinically impaired in patients (P300 latency: 361±38 ms, means±SD) as compared to healthy subjects (344±27 ms, p=0.01). Similarly, P300 amplitude was reduced in patients with HCV infection (12±7 vs. 18±7 µV, p<0.01). Health-related quality of life was significantly reduced in patients with HCV infection but there was no clear correlation between neurophysiological function and health-related quality of life or activity of hepatitis. In 7 out of 9 patients who were followed during antiviral combination treatment, P300 latency was improved after 12 weeks (345±29 ms) as compared to baseline (363±48 ms, p=0.08). In conclusion, patients with chronic HCV infection in the absence of cirrhosis exhibit a subclinical neurophysiological impairment. Cerebral function, however, seems to normalize with antiviral treatment. Our data might indicate a direct action of HCV infection on the brain. A theory that I've heard is that improvement from therapy is due to ribavirin because interferon does not enter the brain. But in HIV it's hypothesized that brain or cognivtive functioning may improve also because of improved immune function and not necessarily due only to direct antiviral drug affect in the brain or CNS.

http://www.natap.org/2000/ddw/rpt_11.htm

[hepCC]

I for one believe hcv can have many effects on the body, many of them yet unknown, some known but not thoroughly researched yet. My own health started to deteriorate a few years ago, and not until tested for "everything" for two years, hcv was found. Among my symptoms are severe fatigue, slowed thinking, problems with concentration, joint pain, headaches and autoimmune skin disease. No other cause than hepatitis was found in all the examinations and tests I've been through. I am 43, not exactly an "old" person. I might have had the virus for a very long time though. My liver is not super either, but I don't have cirrhosis, so I don't think all my problems are due to liver damage.

Myown has supplied some reading material above, and I've seen a more recent study concluding that a slight cognitive impairment and alterations in the brain were present in a significant part of the hcv-patients in the test compared to control group. Couldn't find it right this minute though.

Of course you should get examined by a doctor to rule out other causes, but I think hcv can make you feel like **** the way you describe it.

[Myown]

Myown has supplied some reading material above, and I've seen a more recent study concluding that a slight cognitive impairment and alterations in the brain were present in a significant part of the hcv-patients in the test compared to control group. Couldn't find it right this minute though
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Yeah I have some more recent studies too, but this one (for me) breaks it down to where its not hard to follow and I found this one quite interesting. For some reason it seems that there still isn't enough attention given to how the virus effects that brain. My brain MRI came back with "white matter changes," and I know someone else on forum report stated similiar. I wonder how many other people with hepc would have some type of abnormality show up if an MRI of brain was given - but even then, really, what can they do for us. The above has some "theories" such as ribaviron may help cognitive function. But then again - theory. But I found it interesting - though I don't like thinking about virons in my brain. Yuko.

[DragonSlayer45]

I have also read these reports as I am always looking for any information I can find on HCV. My biggest problem is remembering what i read LOL.

I also realize that doctors and researchers still do not know a lot about this virus as it is relatively new disease (1989). That is one of the reasons I elected to wait in treatment. Current treatment protocols are rough with not great statistics. Being that I am stage 2 and been there with no change I felt I could wait a little. Although some of the cognitive changes are disturbing to me. In particular the irritability really bothers me. I seem to be much less tolerant than I used to be and sometimes short with people (I was always too nice). My wife bears the brunt of it, and I always apologize after when I am a jerk.

I am hopeful that some of the new protease inhibitors and polymerase inhibitors pan out. They are still a long way from being a reality. Hell, they still do not really know how it all replicates.

I sometimes wonder if I should treat but like I said I am not a huge fan of current treatment and I am not convinced of it's long term effect on people. Interferon is not a new drug, it has been around a long time. I once had an infectious disease doctor tell me it was a drug waiting for a disease to happen.

My current Gastro is great and is involved in many trials, goes to all the big meetings and appreciates the fact that I research things thoroughly. He even recommended I go see another doctor at Penn, Einstein, or Jefferson in Philadelphia. He offered up some names and said he would make the call for me to get me in if I want to get a second opinion (whether to treat or not).

[mremeet]

Yes you're getting older and may be experiencing the effects of advancing years. But you have had HCV for a quarter century and yes it can and DOES bring you down. Speaking for myself, I'm a few years younger than you (not much) and have also had HCV for about 24 years. I was infected at 17 and there was a distinct departure from normal energy levels and fatigue/brain fog in my life starting at the age of infection. The chronic fatigue and the other more subtle symptoms would remain in varying degrees all the way up until my late 30's. Then around 39-40 I just felt more run down, even when I was exercising semi-regularly and keeping a reasonably healthy diet. I felt more run down than a man my age should have felt considering my decent weight, general lack of bad health habits (no smoking.very little drinking etc), and reasonable to good fitness level (I exercise alot). This really wasn't surprising though, because at any age between 17 and 40 I was always behind the 8 ball when it came to energy levels. And it's not that I couldn't muster intense energy levels when I had to, it was just that the general average fatigue and mental confusion was much higher than it would have been for a healthy person of the same age (without HCV) at any given point in time. So for me HCV caused very noticeable symptoms in the form of fatigue and mental cloudiness (and other more subtle effects). And these problems seemed to be getting worse as I was entering into my 40’s.

But the strange thing is, is that most of the people I’ve spoken to who also have HCV (and have had it for many years) generally just shrug their shoulders and say “Ahh, it doesn’t really bother me”. Or in other words, they’re asymptomatic – the virus doesn’t make them feel bad. I almost couldn’t believe it when people would tell me that, I mean I could understand how maybe some people would not have symptoms, but it surprised me to learn that the majority do not appear to experience noticeable symptoms.

Getting back to your situation, I don’t know if you experienced significant side effects in the past that may be attributable to HCV. But I’m quite certain there are not just distinctively “symptomatic” and “asymptomatic” HCV patients. Obviously there are many shades of gray in between as well. Some people are partially symptomatic, and some people are intermittently symptomatic, or some experience a combination of the above. Plus there are undoubtedly people who are initially asymptomatic (and perhaps for very long periods of time) but then only later in life develop symptoms. You might be one of these people. But as jim stated, without knowing everything, the rather common/vague symptoms you are having may be attributable to something else (of course including the normal aging process which affects each of us differently at different times during our lives). Still, you do know you have HCV, you do know you’ve had it for many years, you do know there is a substantial body of evidence supporting the correlation between the disease you have and the symptoms you’re experiencing. Therefore, obviously there’s a reasonable to good chance your HCV is at least contributing to your physiological and psychological doldrums.

Speaking for myself, I decided to treat my HCV just last year. I was feeling fatigued and run down as described earlier and feared the disease was advancing and was going to suck even more life out of me. I had held off on treatment for nearly 10 years (diagnosed in ‘97), because I wanted no part of interferon and ribavirin either (especially considering I was geno 1a with minimal fibrosis (F1)). But then along came a VX-950 trial which boosted my odds of treating successfully significantly. So I signed up and started taking all these nasty drugs last summer (summer of ’06).  Long story short: I suffered and went through a bad time (especially because of what VX950 did to me). I finished up 41 weeks later (in June of ’07) and have since achieved my SVR status. But let me tell you that within about 90 days of quitting those nasty drugs, I started feeling fabulous. I mean I’ve felt better in the past 5 months or so than I can remember ever! I feel great, and the funny thing is that I haven’t even been treating myself very well. Not exercising that much (until recently here), drinking way too much beer (my liver can process beer like a frat house now), and eating all kinds of fattening foods. But still I feel great, and now that I’m moderating my beer consumption, eating better and hitting the mountain bike like a wildman, I just feel magnificent! I’m telling you being cured has so far also CURED me of that grinding chronic fatigue that’s been my near constant companion since I graduated highschool. Don’t get me wrong, there are some treatment drug aftereffects I’m still dealing with, but they seem to be fading away and are very manageable anyway (I suspect they will fade to nothing within another year). My god I don’t regret treating and treating when I did, even knowing what I had to go through with the side effects. It was worth it. And now I don’t have to worry about my liver marching forward to F2, F3 and beyond. That fear is behind me now. I just can’t explain how comprehensibly liberating it has been for me. I’ve known I’ve had this disease for 10 years, and it was eating away at me psychologically too. So it’s really something to now know that the rest of my life is up to me how I live it. I may come down with some other kind of ailment like heart disease or diabetes or whatever as I move along the timeline. But HCV ain’t something I’m going to have to sweat anymore. And in the meantime (god willing), this improved energy level and resolution of grinding fatigue lets me stay more active which further helps to stave off other health related maladies. It’s a win-win domino effect and I’m glad to be the recipient of it.

Anyway, I guess my “message” to you is as a person who was up until quite recently in similar shoes as you are right now. I can’t promise you’re going to feel better if you treat and manage to get cured, and I can’t promise you’ll be cured anyway (especially since you’re geno 1). But it is a possibility and perhaps even a likelihood that you could both be cured and resolve much of your fatigue after being cured; depending on how you view the facts as they pertain to your particular situation. Hope you get it sorted out one way or the other.

PS>> Oh yeah one more thing – as far as exercise is concerned, I don’t know how intense your exercising is, but one thing I always found that would help wipe out fatigue (at least temporarily) was *intense* aerobic exercise (3-5 times a week). I don’t know if you really hammer that elliptical machine, but when I mountain bike I ride a single speed bike. And I have to go up difficult hills on that bike, and since I can’t downshift I simply have to force myself up those hills. And unless I’m willing to stop and walk the bike up the hill (which I’m not), I’m always forced into these death climbs that really take you to a place aerobically that perhaps a stairmaster or elliptical machine won’t. Anyway, it’s painful, but it’s an explosive workout. That explosiveness was what made the difference for me in experiencing a fatigue breakthrough. (obviously get a doctor’s approval prior to engaging in any “explosive” workouts etc)

[DragonSlayer45]

Jim,

I understand that all these things change with age but I am not so sure that is it. I talk to healthy people my age and even my wife who is 3 years younger than me and they feel great. My wife said she never has anything that hurts on her. That is why I question it. Maybe I am getting older but thought it might be more with the HCV and was curious if others felt similar. Hell I know about peoples sides with treatment and I tell my wife I could not imagine feeling worse than this for a year!

Also if my enzymes never seem to go up why does my side hurt all the time? I mean I know why it hurts...inflamation (inflammation) but why do my enzymes never change and my biopsy not change? I thought that was a little baffling. My last blood test I was surprised (and relieved) that other than a high VL everything was normal.

I always enjoy your posts by the way as they are very informative and  usually pretty level headed.

[GrandmaA]

I was stage 3 and 64 years old when I decided to treat, after I got an email from Dr. Cecil who said, "If you want to live another 20 years you better treat." I finished treatment 10 weeks ago. Just before Xmas I will have my 3 mo. viral test. I put off tx for over 3 years. Genotype 1a. Exposure blood transfusion 1977. Dx 1997. I had no symptoms for 3 years and liver enzymes were all normal, not even fatigue.

[DragonSlayer45]

Congrats on your SVR, that is pretty encouraging knowing that you have regained all of your energy and all the positive experiences you just shared. I have thought about trials as well. like I mentioned I backed out of trying the NM283 trials with Riba and peg (it ended up getting shelved anyway). I also know that it is not a forgone conclusion that standard treatment will not work with me, it very well may. i just know that as a male, geno 1 (like most of us) and a high VL the odds get a little worse. I also know that some people have very few sides and some recover really well after with no long term sides. I also know some people who could not finish treatment and some who have all kinds of problems after treatment they never had before. These are not people I read on the forum but people I have actually met or know personally.

As far as exercise I work out 5-6 days a week but do not go wild My heart rate averages 125-135 for 50 minutes with peaks of 155 or so. I also like the rowing machine (concept 2) I really enjoy it. I put a gym in my basement that is really nice with a treadmill, elliptial, rower, and weight machine. I was always afraid that if I hit it too hard that it may not be a good idea (too hard on liver).

[Myown]

Although some of the cognitive changes are disturbing to me. In particular the irritability really bothers me. I seem to be much less tolerant than I used to be and sometimes short with people (I was always too nice). My wife bears the brunt of it, and I always apologize after when I am a jerk.
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I can relate to what you are saying. I'm much less tolerant also. Not that I was ever real tolerant to begin with,,but I was never like this. Its not all the time, but I do get mood swings and just like your wife - my husband bears the brunt of it. Its not a daily thing.

My husband has always been the type that takes his time doing things and doesn't stress out. I have always admired that about him. The other day I must have had a viron explosion in my brain and I was ready to lose my mind waiting for him to finish telling me this story of something that had happened in his day. I finally said "wait, wait , please.,,,I'm in one of those "0 tolerance" moods,,,can you please talk a little faster, this story is taking too long. I felt terrible saying this, but he was talking too slow for me. Is that nuts or what? Its not like he was talking abnormally slow, I just didn't feel like listening. But also my DHEA is 3x's higher than what it is supposed to be and the more I research that, its helping me understand some things that are going on with me too. I just read that high levels of dhea can cause aggressiveness! Just what I need - sounds like the equivalent of my body producing its very own "ribaviron."  But anyhow I don't know how your wife handles apologies, but my husband is good. He hasn't thrown the "how can you be like this after all I have done for you," line yet. But he's not like that so he won't. I always tease him and ask do you regret the words "till death do us part?" And so far he always says "of course not." whew!

I just saw in your profile that you are from Jersey. Me too. Thats funny. Hey,look at your front door right now and wave.I'll do the same. If we both see somebody waving - that means we're neighbors.

Talk to ya again.

[DoubleDose]

This is still a very gray area because of a real lack of quality studies on brain function, and a lack of interest in the medical community.  The liver receives almost all the focus, and all the other issues are somewhat ignored because the feeling is that they are not life-threatening.

At the same time, the brain and CNS issues are the most taxing and concerning to me, and many others over time.  It is why I treated (Twice) to get the SVR, and am still working toward a slow return to more normal function.  I won't get into post-tx issues, or symptoms because that is an even more 'gray' area, but I will say that I am absolutely certain that active HCV infection, regardless of liver damage, can affect the brain, and nervous system function very powerfully.  Asymptomatic people are very fortunate, because those more on the other end of the HCV symptom spectrum can experience very disturbing, and life changing problems that make you feel like a 'misfit' within the world.
Tired, anxious, withdrawn, arthritic, confused, poor memory, headaches, eye and sight problems, swollen salivary and parotid glands, and a general lack of motivation, etc. etc.

These are some of the many symptoms I experienced over the years from HCV, in my 20's and 30's.  Well before the impact of ageing (aging), or years of work and toil.

The disease is very insidious, and has both subtle and overt manifestations, but the great majority of research and focus is, and probably will remain, on the Liver.  Unfortunately, it may take quite a while to learn what we need to understand about the virus!

DoubleDose

[Myown]

There's no doubt in my mind HCV affects the brain. My mind has a pause button that gets stuck alot too. I'm serious. Its scary to me. Its as if I am in another world. Someone can say something to me and I will take it totally wrong until I think about it later on. I get tired of it. Its very frustrating. Brain fog is ridiculous. And I don't believe its the interferon at this point. I think its the virus. But it gets really bad at times where I totally forget to do something that someone (usually my husband) asked me to do - within minutes too. For instance "Myown, can you bring me something to drink?" Yeah just a second,I'm doing something. Five minutes later "honey, I'm watching the game, can you bring me that drink?" OMG, then I'll say,,,,"see this is what I mean,,,how could I have totally forgotten until you said something again in that short period of time?"  I hate this, it drives me crazy. I have those 'stick ums" or whatever they are called all over the place. I keep some in each room so that I can write myself notes if I have to do something. It really does get me down at times. Some people it may not effect as much as far as brain and they either think we are crazy or something I guess, but its very real. Another reason I would never go on Ad's - though I would never tell someone not to if they need them. But to me taking Ad's would give me a false sense of security and everything would be happy happy joy joy and I wouldn't really know what is going on with my body and mind - if that makes any sense to you. I want to know exactly how this virus is making me feel mentally and physically and to be able to let my doctors all know cause eventually they might hear others say the same thing. I really don't know how many or who continues to take AD's after tx is over, but a doctor is never going to hear how the virus or occult is causing deppression if they are on AD's. Not saying people shouldn't take them if thats what they need or choose though.

OMG no wonder I am so tired and rambling on - its 12:55 AM. I cant believe it. Good Night - Nice talking to you.

[moahunter]

I am one of the rare few who actually got acute symtoms after infection (worst patch lasted a couple of weeks) - my Alt went to more than 900. At that time, I had pain on my right side (I guess as my liver was bloated up, pushing on my rib cage), acidic stomach (not suspposed to be a symptom, but what I had), blood red urine, but most importantly, terrible brain fog. I was unable to even concentrate enough to watch TV. I suspect that chronic Hep C ends up the same way eventually, just a matter of time. Many people may not even realize how low their energy is, as they do not remember what it is like to be healthy, as they have been sick for so long. Hope things work out for you.