inflamed joints

[dianarose52]

I have hep c genotype 1a , did trial did not work for me back in I think 2009.  I am having pain severe enough to ge cortisone shot.  Bursitis now too.  My memory is terrible also.  Is this all do to Hep. C?

[orphanedhawk]

Looking at your profile I see that you've posted about light colored stools and you are 60. Your last biopsy was in 2008.
I suggest you get another biopsy and find out what condition your liver is in.
Have you seen a hepatologist ? I'd suggest seeing one experienced in treatment of hep C.

As will so wisely stated, nobody knows your problems or history.
These symptoms can be related to many things~ too many to speculate not knowing you, your history and not being medical professionals.

Best of luck~
OH

[Ironpony]

me too Dawn;) I do believe when my virus left it was the same for me.


I am looking forward to being HCV free after I end tx today....

I am more relieved then worried that I have done INF and treatment knowing I didn't let HCV ravage my WHOLE body and liver.The last thing I want to think of today is the long term affects of INF.

To OP:  I hope you find the answers you need...and as Will stated:


No one here would definitively be able to ascertain  what your problems and pain are caused by other than a doctor familiar with your history ..

[Dawn703]

Many of my extrahepatic manifestations subsided or completely went away 2-3 weeks after starting treatment.  

[Dee1956]

Thank you :)

[rambleon40]

The study on the "Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States" is offered only because it contains a conflict of interest disclosure from Herbert Bonovsky, MD (the author pooh cited) stating that he earns income from InfaCare Pharmaceuticals, Novartis Pharmaceuticals, Ovation Pharmaceuticals, Merck, Novartis, Roche, and Vertex.

His name pops up a lot in cursory Hep C research on the web.

So the main thrust of the article has nothing to do with this thread - Bonovsky's disclosure, however, does.  

That patient 16 is interesting, too.

[rambleon40]

Thank you very much for that.  

Observations:  

1.  The research cite no. 28 states that x% of Hep C folks have abnormal thyroid (3.4%), arthralgia / arthritis (23%), myalgia (15%) etc.

2.  The mean age of participants was 46.7 years old.

3.  There were 90 folks out of 1614 who had undergone organ transplants.

4.  Exclusion criteria were: a) Hep B exposure, and; b) HIV.  What about prior interferon treaters?   It says "first visit" was the group, but "first visit to that big center?"  or "first visit ever to any place for Hep c?".  With 90 organ transplants in 1614 participants, these aren't just the "man off the street."  

5.  The study itself states that there is no control group.  (See page 2207, 2nd paragraph under "Discussion")

Questions:

1.  So how do % of people with these ailments compare to the population at large?  how much difference?

thyroid - 27 million americans w/ thyroid problems (8 or 9%?)  http://health.usnews.com/health-news/family-health/heart/articles/2008/09/22/low-thyroid-function-linked-to-heart-failure-risk

(I don't entirely trust that cite)


Arthritis - 22% or so of general population have it - http://www.cdc.gov/arthritis/data_statistics.htm (very near the 23% reported in article)

(note - study is French - my figures are American - societal dietary and lifestyle differences may be relevant to interpreting results, against "my" position and in support of validity of "yours" - it's a maybe.)

2.  at 46.7 years of age, don't more people have arthritis, etc, anyway?  most folks are stating to break down a bit by then.  

3.  organ transplants and associated drugs almost have to significantly alter results.  

4.  there may be a number of prior interferon treaters in the group - can't tell for sure, I don't think.  

5.  question is evident from the observation - how valid or significant are results w/ no control group to compare them against?  

more food for thought.

Off to bed.  I gotta get a life.

[Idyllic]

I don't get what a study on the "Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States" has to do with the OP's question. She's wondering about pain, bursitis and her memory.



Here is the results of the study in your link:
DILI was caused by a single prescription medication in 73% of the cases, by dietary supplements in 9%, and by multiple agents in 18%. More than 100 different agents were associated with DILI; antimicrobials (45.5%) and central nervous system agents (15%) were the most common. Causality was considered to be definite in 32%, highly likely in 41%, probable in 14%, possible in 10%, and unlikely in 3%. Acute hepatitis C virus (HCV) infection was the final diagnosis in 4 of 9 unlikely cases. Six months after enrollment, 14% of patients had persistent laboratory abnormalities and 8% had died; the cause of death was liver related in 44%.

[Idyllic]

In will's post the emedicine article the first paragraph is related to folks with decompensated cirrhosis. But the third paragraph references a different study & body of people. You have to click on the [28] for more details.

It is where it says these symptoms
Arthralgias (23%)
Paresthesias (17%)
Myalgias (15%)
Pruritus (15%)
Sicca syndrome (11%)

if you click on the reference [28] it is data from this study:
http://reference.medscape.com/medline/abstract/10524695


"To analyze the natural history of extrahepatic manifestations of HCV infection, we reviewed only the data recorded prospectively during the first visit of 1,614 patients with chronic HCV infection, coming from a single monocenter cohort. "

http://www.ncbi.nlm.nih.gov/pubmed/10524695

[rambleon40]

By the way, check out Patient 16 in Table 5 in the article I that I offered with Bonkovsky's conflict of interest disclosure

http://www.gastrojournal.org/article/S0016-5085(08)01674-0/abstract

[rambleon40]

Now this article has some meat but ......

Question:  what are the %s / likelihoods of the extrahepatic symtpoms described?  i have not taken the time to pursue the citations in the article.  Could be very low %s; could be relatively high.

Observation:  The article ends essentially with "[Watch out for these things so that you can get into early treatment.]"  The author (Bronovsky) has a conflict of interest description in one "Gastroenterology" journal article that states in relative part:

"H.L.B. served as a paid advisor to InfaCare Pharmaceuticals, Novartis Pharmaceuticals, and Ovation Pharmaceuticals. He is on the speakers' bureau of Ovation Pharmaceuticals. He receives support for research studies from the American Porphyria Foundation, Merck, Novartis, Roche, and Vertex..."

http://www.gastrojournal.org/article/S0016-5085(08)01674-0/abstract

food for thought

[rambleon40]

Also,  the emedicine article cited describes symptoms of patients with decompensated liver disease (ie - cirrhosis so bad that liver can't function right), and states that almost all patients with Hep C will be asymptomatic....

[rambleon40]

What dianarose describes are classic side effects of interferon treatment, will.  

[pooh55811]

That's a very good question.

That constant inflammation from the body fighting the Hep C virus is no longer there (if one attains SVR) so I would think there would be an improvement in at least some of the symptoms.

Also, you may recall that there are 2-3 people on the forum who are treating their Hep C because otherwise their (Hep C triggered) lymphoma will come back.

Also, just from personal experience, I have noticed over the last 2 to 2.5  months that many of the symptoms that I had before treatment are totally gone now (and I am only at week 45 of treatment). These include back pain, joint pain and stiffness, no energy, fatigue. I am sure there are more but I don't think about them because they are gone.  

Here is an article from HCV Advocate which lists some of the extra-hepatic problems and, if you read down to the Cryoglobulinemia section, the Lymphoma section and the eye section, you can see that treatment of the Hep C resulted in remission of the Lymphoma in those who attained SVR. Also, some of the eye problems (corneal ulcers) cleared up with Interferon treatment.  And the skin lesions from Cryoglobulinemia cleared up.

http://www.hcvadvocate.org/hcsp/articles/Bonkovsky-2.html

[Idyllic]

Do extrahepatic manifestations of Hepatitis C tend to subside after antiviral treatment (treating & clearing the virus)?

[willbb]

Sorry ..forgot the link::
Other Systemic maladies from HCV

Jul 13, 2012 - 7 comments - (Public)


It is only recently that "Extra hepatic Manifestations "(other than the liver) are coming to light from having HCV.
It is not always "only "what fibrosis stage one has that may be factered into when may be the best time  to treat.

/emedicine.medscape.com/article/177792-clinical

Symptoms often first develop as clinical findings of extrahepatic manifestations of HCV and most commonly involve the joints, muscle, and skin. In a large study of the extrahepatic manifestations of HCV, 74% of medical workers with HCV infection demonstrated extrahepatic manifestations.[27] The most commonly occurring extrahepatic manifestations were as follows:

Arthralgias (23%)
Paresthesias (17%)
Myalgias (15%)
Pruritus (15%)
Sicca syndrome (11%)
In addition, sensory neuropathy has been reported as an extrahepatic manifestation in 9% of patients with HCV infection.[28] Risk factors for manifestations of extrahepatic chronic hepatitis C infection include advanced age, female sex, and liver fibrosis.

[willbb]

Hi,

It has come to light in the last few years in the medical community that there are a number of extra-hepatic (outside of the liver) conditions that are directly or indirectly causal from HCV.

Some are outlined below.

No one here would definitively be able to ascertain  what your problems and pain are caused by other than a doctor familiar with your history ..

Good luck and welcome to the group..
Will