Looking for Articles on HCV- Peg. Interferon alpha 2-a - Fibromyalgia connection

[meki]

Folks - looking for a connection here - and I need to cite some professional articles to my doctor so that he will actually BELIEVE that the possibility exists that I am having arthritic like pain in my muscles/tendons throughout my body --- based on my belief that Interferon TX may have caused an autoimmune disorder.

My local General Doc here (which is about all that I have... right now -- not flying off the island just yet) - doesn't have a lot of knowledge about HCV, Fibromyalgia or Interferon TX --- connections.

In trying to explain to him that I believe that the current pain I'm in is Fibro and I think that the TX I took may be the culprit --- I get a glassy eyed "sure hon" look. Here, take these pills --- call me in a week if you still feel uncomfortable.  And he quotes that flu like symptoms and the other "MILD" symptoms should now be gone... LOLOLOL! Anyhow...


My "self-diagnosis" is based on research online --- and talking to quite a few folks - and yeah - I'm open to the possibility it could be arthritis - but it's pretty much pain in multi areas --- tenderness that feels like I need a DEEP TISSUE massage constantly - achey --- uncomfortable in my own skin, kind of like bruised feeling and tenderness in my neck, upper back, shoulders, middle arm joints, hips in the back and in the front, middle back stiffness, under the pelvic bone behind the back --- top of femur area in back and at juncture of pelvis to top of thigh internally, knees and sometimes but rarely ankles... I get frequent headaches and I'm pretty much tired --- in that my mind is wide awake but I just don't have the energy to jump up and do things. The pain subsides while I'm being massaged (the dear hubby is a doll --- and I can go to sleep while he's doing that...) However, I've made him buy us 2 different beds, because I thought I was feeling like that because of the beds themselves... But I've tried other beds, the couch, the floor, a futon - the board under the mattress trick --- and finally the memory foam toppers... Nothing is helping - not exercise and diet --- not just being lazy and lying around --- not having great sex... LMAO!!!   And just getting comfortable is very difficult for me --- in order to even fall asleep - I'm getting about 4 hours a night, if I'm lucky... And prior to TX --- 8 hours would be a bare minimum for me... LOL --- I like my sleep...

I realize getting another doctor would be the most likely point. However - I'd really like to educate my doc... So that the next person going to him doesn't get that blank eyed look.

I believe that what I'm feeling is pretty much Fibro - but like I said - arthritis is a possibility as well. Both sides of my family have arthritis in them... etc. ad infinitum.

SO --- with that said...

I'm looking for articles that are citeable - that would provide the information he needs to put 2 and 2 together to come out with a firmer understanding that this is possible - and that I need further looking at instead of just handing me a couple more pills until next week to stave off things.

I'm all for pain meds, if they're necessary... as I hate pain and have a lower pain tolerance than most folks --- But I'd really like to not be treated like an idiot and just handed pills -  since I know my own body. And I'd like to maybe start working on arthritis or fibro issues --- whatever it takes. I'd also like to not put meds in my body that are not liver friendly - and I'm not sure that the "COX" drugs are so good for me.

So if any of you have special sites that you belong to that has the connection or has listed the association of HCV or Pegylated Interferon Alpha 2a (or even Riba) to Fibro or other pain disorders that match the key points I have above...

I would be eternally grateful.

I've done some google - and have read some points... But there are a few of you on here who are far beyond me in research capabilities ---- and some of you have almost God-like connections... LOL!


Meki

[gothic0ne]

I was threatened successfully with Pegintron(2a) and Copegus (Ribavirin) this year at the university clinics of Hamburg Eppendorf (UKE). I had for 4 month totally less sideeffects like influenca feelings the first 2 days after the injections, disfunctions in sleeping and tiny depressions. The last two month of my threatment were a horror. I have also a disease at my vertebrae (Scheuermann- Disease and other disfunctions) and this was getting much worser the last two month of the threatment. The threatment ended with a lung inflamnia (pneumonia) - BUT it was SUCCESSFULL - my HCV (Genotype 3) is GONE. What I want to say: The doctors who threatened me at the UKE were very good. The doesn´t ignore any report  from me about my sideeffects - at one consultation I searched the web with her to find reports about similar problems like my problem was - we found solutions!!! Maybe it will help if you ask your doctor to contact the:

Universitätsklinik Hamburg Eppendorf - Ambulanzzentrum des UKE GmbH Bereich Virushepatologie   email:   ***@****

On this side you find all informations about the Hamburg Hospital:                             www.uke.de  
Maybe this contact will help that your doctor taking your reports more serious because one of the main issues of the UKE is to find more about up to now not reported sideeffects in the threatment and correlations / interactions with other diseases. And reporting about your case will maybe help in the research what maybe will be the inducement for your doctor to report it - and this will finally help you to work closer together with the doctor to find a solution for your problem.
From Hamburg Germany the very best wishes for your recovery and your life sents  Josef

[meki]

Jim - anyone with super human research powers?

HR --- you seeing any correlation between any of these things?

Meki

[meki]

I checked that - very one sided - but does have a connection to RA - autoimmune stuff.

Thanks for that link.

I go in on Friday at 4... So if anyone else has some good research papers or anything connecting the 2 - please let me know.

Meki

[Wassup]

@ my GI, dr visit today, I was given a book called "The Hepatitus Workbook" A guide to living with chronic Hepatitus C  The have a program called "Be In Charge"  The may be a little one sided in that they a service of Schering Corp.  

These people mfg. PEG -INTRON (pEGINTERFERON ALFA 2B) AND REBETOL, (RIBAVIRIN, USP).  

Phone # : 1 888-***-****
Web Eddress : www.****.com  

Hugs aplenty, and good luck,  Ant B

[meki]

If you guys come up with any more - let me know...

I'm also looking for LIVER FRIENDLY medications to ease the painful sides on days when I can't handle it.

Meki

[meki]

You guys are awesome - I'll take all that you can get - and more.

Thank you so very much.

Meki

[eureka254]

Clin Rheumatol. 2001;20(4):297-9.
    Rheumatoid arthritis induced by alpha-interferon therapy.
    Passos de Souza E, Evangelista Segundo PT, José FF, Lemaire D, Santiago M.
    Universidade Federal da Bahia, Salvador, Brazil.

    Interferon (IFN) therapy has been used for the treatment of common diseases such as hepatitis C, myeloproliferative disorders, autoimmune diseases and various types of cancer. Given the biological properties of interferon, it is not surprising that there are a larger number of side effects due to its use. Although rheumatoid arthritis (RA) is one of the most common autoimmune diseases found in clinical practice, it does not seem to be frequently related to IFN therapy. We report a 40-year-old female patient who, after high doses of IFN-alpha therapy for malignant melanoma, developed symmetrical polyarthritis, with pain and oedema in small and large joints, associated with prolonged morning stiffness. She had positive rheumatoid factor and DR4 HLA phenotype. She was treated with deflazacort (6 mg/day), chloroquine and NSAIDs, with a partial response. In conclusion, although the development of RA after IFN therapy is a rare event, IFN may work as a 'trigger' for such complication, leading to deregulation in the immune cascade in a person genetically predisposed.

[eureka254]

Current Opinion in Rheumatology: Symptoms and complications of Interferon Therapy
Author(s): Borg, Frances AY; Isenberg, David A
Issue: Volume 19(1), January 2007, p 61–66
Publication Type: [Systemic disorders with rheumatic manifestations]
Publisher: © 2007 Lippincott Williams & Wilkins, Inc.
Institution(s): Department of Rheumatology, University College London Hospital, UK
Correspondence to Dr Frances Borg, Department of Rheumatology, University College Hospital, 3rd Floor, 250 Euston Road, London NW1 2PQ, UK Tel: [phone]; fax: [phone]; e-mail: frances.***@****


Abstract
Purpose of review: Interferons are used to treat a variety of medical conditions. They are integral players in immunity and a number of immune-mediated complications can arise during interferon therapy. We have reviewed the occurrence of these complications, and the mechanisms behind them.

Recent findings: Case reports and follow-up studies of large cohorts of patients on interferon therapy have confirmed that immune-mediated complications are uncommon but can occur in a number of different organ systems. IFN[alpha] production is induced by specific autoantibody–nuclear antigen immune complexes, and has a key role in the development and maintenance of autoimmunity in systemic lupus erythematosus.

Summary: Interferon therapy can precipitate immune-mediated abnormalities de novo or can exacerbate an existing autoimmune tendency. This is manifest in the rise in titre of existing antibodies and in the development of clinical disease in patients with preexisting antibodies. Type I interferons have a key role in the development of systemic lupus erythematosus.

[debnevada]

that's definitely the case with me.  The kicker are differences in my labs  CRP and ana have now shown their ugly faces, where they were normal and absent respectively, before.  Symptoms are joint pain and some soft tissue pain.  My guess is that the lack of sleep is becuase of discomfort.  And this is not minimal stuff.  Yesterday was so bad that i was having serious trouble walking..

my dear internist, dan rollins is treating me with placquenil because steriods are still a no-no. it is called in my case drug induced lupus

[hippygem]

Titre du document / Document title
Fibromyalgia in hepatitis C virus infection : Another infectious disease relationship
Auteur(s) / Author(s)
BUSKILA D. (1 2) ; SHNAIDER A. (2) ; NEUMANN L. (3) ; ZILBERMAN D. (2 4) ; HILZENRAT N. (2 4) ; SIKULER E. (2 4) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Rheumatic Disease Unit Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, ISRAEL
(2) Department of Medicine B, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, ISRAEL
(3) Department of Epidemiology, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, ISRAEL
(4) Liver Disease Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, ISRAEL
Résumé / Abstract
Background: Fibromyalgia syndrome (FS) is a common disorder of diffuse pain in the muscles or joints accompanied by tenderness at specific tender points and a constellation of related symptoms. The potential role of infections in the pathogenesis of FS has only recently been investigated. Objectives: To evaluate the prevalence of FS and to assess tenderness thresholds in patients infected with hepatitis C virus (HCV). Methods : The study included 90 patients with HCV, 128 healthy, anti-HCV-negative controls, and 32 patients with non-HCV-related cirrhosis. Tenderness was measured by manual palpation (18 tender points) and with a dolorimeter. Fibromyalgia syndrome was diagnosed according to the 1990 American College of Rheumatology criteria. Results: The diagnosis of FS was established in 14 patients (16%) with HCV, in 1 patient (3%)with non-HCV-related cirrhosis, and in none of the healthy controls (P<.001). Thirteen of the HCV-positive patients with FS were women. The patients with HCV had significantly (P<.01) more tender points (mean [±SD] 3.6±5.3) than the healthy controls (0.1± 0.5) and the patients with non-HCV-related cirrhosis (1.2±2.7). Specifically, the patients with cirrhosis were most tender on both tenderness measures owing to the high proportion of women in this group. Patients with FS were significantly more tender than those without FS: their dolorimetry thresholds were 2.9 kg vs 6.0 kg (P<.001). Conclusions: A high prevalence of FS was observed in patients infected with HCV, especially women. Recognizing FS in patients with HCV will prevent misinterpretation of FS symptoms as part of the liver disease and will enable the physician to reassure the patient about these symptoms and to alleviate them.
Revue / Journal Title
Archives of internal medicine   ISSN 0003-9926   CODEN AIMDAP
Source / Source
1997, vol. 157, no21, pp. 2497-2500 (20 ref.)
Langue / Language
Anglais
Editeur / Publisher
American Medical Association, Chicago, IL, ETATS-UNIS (1960) (Revue)
Mots-clés anglais / English Keywords
Viral hepatitis C ; Prevalence ; Risk factor ; Fibromyalgia ; Comparative study ; Symptomatology ; Evaluation ; Human ; Pain ; Viral disease ; Infection ; Digestive diseases ; Hepatic disease ; Diseases of the osteoarticular system ; Striated muscle disease ;
Mots-clés français / French Keywords
Hépatite virale C ; Prévalence ; Facteur risque ; Fibromyalgie ; Etude comparative ; Symptomatologie ; Evaluation ; Homme ; Douleur ; Virose ; Infection ; Appareil digestif pathologie ; Foie pathologie ; Système ostéoarticulaire pathologie ; Muscle strié pathologie ;
Mots-clés espagnols / Spanish Keywords
Hepatitis virica C ; Prevalencia ; Factor riesgo ; Fibromialgia ; Estudio comparativo ; Sintomatología ; Evaluación ; Hombre ; Dolor ; Virosis ; Infección ; Aparato digestivo patología ; Hígado patología ; Sistema osteoarticular patología ; Músculo estriado patología ;
Localisation / Location
INIST-CNRS, Cote INIST : 2040, 35400007940217.0120

[hippygem]

Fibromyalgia-associated hepatitis C virus infection

J Rivera, A de Diego, M Trinchet and A Garcia Monforte
Rheumatology Unit, Hospital General Universitario Gregorio Maranon, Madrid, Spain.

The objective was to determine whether there might be an association between hepatitis C virus (HCV) chronic infection and fibromyalgia (FM). We determined the prevalence of HCV infection in 112 FM patients, in comparison with matched rheumatoid arthritis (RA) patients from the out-patient clinic of a teaching tertiary care general hospital. Furthermore, we looked for evidence of FM in 58 patients diagnosed with chronic hepatitis due to HCV, compared with matched surgery clinic patients, HCV antibodies were determined by enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA). Serum RNA of HCV (HCV-RNA) was determined by polymerase chain reaction. In the group of FM patients, HCV antibodies were found by ELISA in 17 (15.2%) patients and in six (5.3%) of the RA controls (P < 0.05). RIBA was positive in 16 and indeterminate in one of the FM patients. Serum HCV-RNA was found in 13 of these FM patients. In eight (47%) FM patients, alanine aminotransferase (ALT) was normal, although HCV-RNA was detected in four (50%) of them. In the group of patients with chronic hepatitis due to HCV, all patients had HCV antibodies and the presence of HCV-RNA in serum. Within these patients, 31 (53%) had diffuse musculoskeletal pain, while six (10%) fulfilled FM diagnostic criteria. In the control group, 13/58 (22%) had diffuse musculoskeletal pain (P < 0.001), whereas only one female patient (1.7%) fulfilled FM criteria (P < 0.05). Serum ALT was 51.7 +/- 38.4 in FM patients, whereas it was 122 +/- 76.3 in patients with HCV chronic hepatitis but without FM (P < 0.001). There were no statistical differences in autoimmune markers between patients with and without FM. These data suggest that there exists an association between FM and active HCV infection in some of our patients. FM is not associated with liver damage or autoimmune markers in these patients. HCV infection should be considered in FM patients even though ALT elevations were absent.

[hippygem]

Fibromyalgia, an often misunderstood condition involving widespread muscle pain and fatigue, is characterized by a set of symptoms, but no definitive test exists to "prove" that a person has it. Some researchers suspect that viral illness could be a trigger, for both fibromyalgia and a similar condition called chronic fatigue syndrome. Research has shown that a subset of people who get Lyme disease, parvovirus, or Epstein-Barr virus—which causes mononucleosis—may later go on to develop one or the other. "What we think is that viruses are one type of biological stress" that may act similarly to physical trauma, a known trigger for fibromyalgia and chronic fatigue syndrome, says Daniel Clauw, a rheumatologist and professor of medicine at the University of Michigan. "There's a lot of different biological stresses, including psychological stress, that seem to be capable of triggering these illnesses." As many as 1 in 50 Americans has fibromyalgia, most of them women, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

A recent book, The New Fibromyalgia Remedy: Stop Your Pain Now with an Anti-Viral Drug Regimen, delves more deeply into the connection and suggests that antiviral medicine and food allergy treatment can be quite effective. Author Daniel C. Dantini, a Florida otolaryngologist who himself has fibromyalgia, says he believes that fibromyalgia is caused by the Epstein-Barr virus, cytomegalovirus, herpesvirus 6, or parvovirus. He says antiviral medications work in 70 to 75 percent of his patients, along with massage and other therapies. Using Dantini's treatment method, most patients see their symptoms improve by "about 20 to 50 percent during the first four weeks," the book says. By six weeks, most chronic symptoms are totally resolved. Most people take the antiviral medications for 10 to 14 weeks, while others need the drugs for up to six months, the book says.

In an interview with U.S. News, Dantini discussed his thoughts on fibromyalgia and how best to treat it. Excerpts:

Do you think other viruses are a concern as well?
Other viruses like hepatitis and Lyme disease can do this, too. Any chronic infection can tend to give these sorts of symptoms.

What treatments do you propose?
The treatments are twofold because this is a complex disease. Control the viruses using the antiviral drugs famciclovir (brand name Famvir) or valacyclovir (Valtrex). What we find in these people who have active disease is they start developing inhalant allergies. They also develop allergies to things they eat. Treatment through diet and, if a person has severe inhalant allergies perhaps using allergy shots, controls the immune system and allows it to calm down. Then most of the allergy symptoms go away.

Since antiviral medications aren't specifically approved for this purpose by the Food and Drug Administration, would people face obstacles with insurance coverage?
Most insurance plans will cover the medicine. Viral testing is usually covered, and food allergy testing is mostly covered.

Your book discusses the role of multivitamins in treating fibromyalgia. How might they be useful?
I don't think a vitamin alone will make you better. These are chronic diseases. I never tell anyone that vitamins will make you better, but they might keep you better.

Would the treatments you describe in the book be used in conjunction with other therapies, like yoga, exercise, and other types of medications? How so?
I tend to tell people to use massage and stretching exercises but that exercise during a flare-up makes the pain worse, so I don't think that's the prudent thing to do. Most of the time when I see patients, they're on any number of antidepressants. Some of them are addicted to narcotics—all of which I think are the wrong way to go about treating this disease.

http://health.usnews.com/

[eureka254]

Not the most up-to-date stuff, but if I find more I'll send it along...

[eureka254]

Trying to find some more up-to-date stuff for you, but some older stuff:

Biomed Pharmacother. 1999 Jun;53(5-6):242-54.
"Autoimmunity induced by interferon-alpha therapy for chronic viral hepatitis."
Dumoulin FL, Leifeld L, Sauerbruch T, Spengler U.
Medizinische Klinik und Poliklinik I, Universität Bonn, Germany.

Type I interferons, which are mostly alpha-interferons (either as single agents or in combination with antiviral drugs), are currently the standard therapy for chronic viral hepatitis B, B/D, and C. Side-effects are not uncommon and include exacerbation of pre-existing autoimmune disorders or the de novo induction of autoimmunity. These adverse effects are attributed to the immunomodulatory properties of type I interferons…

and, this may put you in the minority category, but discusses the fact that autoimmune-athritis DOES happen...

Semin Arthritis Rheum. 1998 Jun;27(6):360-5.Related Articles, Links
Alpha-interferon-induced arthritis: clinical presentation treatment, and prevention.

Nesher G, Ruchlemer R.

Rheumatology Service, Shaare-Zedek Medical Center, Jerusalem, Israel.

OBJECTIVE: The therapeutic applications of alpha-interferon (IFN) have expanded greatly to include chronic viral hepatitis and malignant disorders. Autoimmune phenomena occur frequently with IFN therapy, but arthritis is uncommon. We describe the clinical features and treatment of IFN-induced arthritis. METHODS: A patient with chronic myelogenous leukemia who developed arthritis secondary to IFN therapy is presented. The clinical features and treatment of this condition in 37 additional cases are reviewed. RESULTS: The most common clinical presentation was symmetric polyarthritis. This was associated with antinuclear antibodies in 72% of patients and rheumatoid factor in 34%. Cessation of IFN, with or without the addition of antiinflammatory or remittive agents, resulted in remission of arthritis in 89% and 71% of the cases, respectively. Restarting IFN therapy resulted in recurrence of arthritis in 63%. In the patient described in this report, recurrence of arthritis was prevented by coadministration of hydroxychloroquine (HCQ) and prednisone. CONCLUSION: Arthritis is an uncommon complication of IFN therapy; but it may lead to cessation of this treatment modality. In such cases, coadministration of a remittive agent such as HCQ may enable reinstitution of IFN therapy without recurrence of arthritis.

[meki]

Anyone???