arthritis and hepatitis

[Jack57]

Thank you for your information about liver biopsy. It is great to get this info from all of you who have been through it. I am now planning to go through with the biopsy the end of next week.
Thank you again!

I have one more question, Dose any one have arthritis? I do, and I am wondering if there is a connection between  my arthritis and hepatitis.

[alagirl]

RA is a listed and recognized (at least by the experts, if not by the idiots who sometimes masquerade as doctors in the 'real' world), extrahepatic manisfestation of hepatitis c.

Additionally, RA is one of the many auto-immune diseases that can be brought on by treatment of HCV - I believe this is due to the interferon component of the drug cocktail? Somebody can jump in there on that one.  I have such extreme joint pain on treatment I literally have to have my son help me move my legs in the morning so I can get up.  They are just too stiff and painful.  It's from the treatment drugs though.  I was having joint pain that was new when I had acute hep c, but it was not as bad as the pain I'm experiencing with the tx drugs and the vastly increased epogen I take to try to keep my blood count up.

http://www.hcvadvocate.org/hcsp/articles/Bonkovsky-2.html
Extrahepatic Manifestations of Chronic Hepatitis C
Roderick Remoroza, MD, and Herbert Bonkovsky, MD

RHEUMATOLOGIC and AUTOIMMUNE MANIFESTATIONS
Myalgia (muscle pains), fatigue and arthralgias (joint pains) are common manifestations of HCV infection. HCV-related arthritis commonly presents as symmetrical inflammatory arthritis involving small joints. The joints involved in HCV-related arthritis are similar to rheumatoid arthritis (RA). This sometimes makes it difficult to differentiate true RA from HCV patients with positive rheumatoid factor but without RA. HCV-related arthritis is usually non-deforming and there are no bony erosions in the joints. A marker called anti-keratin antibodies has been studied to differentiate true RA from HCV related arthritis. In a recent study, 71 patients who were rheumatoid factor positive were tested for anti-keratin antibodies. Anti-keratin antibodies were detected in 20/33 (60.6%) patients with true RA and only 2/25 (8%) patients with HCV-related arthritis (10). Patients with HCV-related arthritis seldom respond to anti-inflammatory medications, and although there are no controlled trials to address this issue, it has been recommended to treat these patients with combination antiviral therapy of interferon and ribavirin (11).

Sjogren’s syndrome (SS), an autoimmune disease characterized by dry eyes and dry mouth has been found in some studies to be more common in HCV infected patients. They differ from primary SS in that they do not have lung and kidney involvment. Thus it is recommended to test for HCV infection in patients with SS or primary SS. A study by El-Serag of 34,000 veterans failed to show a significant association between HCV infection and diabetes, SS, or autoimmune thyroid disease (9).

Interferon therapy of HCV infection may also trigger the development of autoimmune diseases, the most frequent of which is autoimmune thyroiditis (Hashimoto’s thyroiditis). This may lead transiently to hyperthyroidism, but eventually to hypothyroidism (underactive thyroid) and to the need for life-long thyroid replacement therapy (Bonkovsky & Mehta).

http://www.asm.org/Media/index.asp?bid=31134

Arthritis due to chronic Hepatitis C virus infection
44th ICAAC
A meeting of the American Society for Microbiology
October 30 – November 2, 2004, Washington, DC
For more information on any presentation at the 44th ICAAC contact Jim Sliwa, ASM Office of Communications at
***@****

EMBARGOED UNTIL: Sunday, October 31, 2004, 2:00 p.m. EST
(Session 116, Paper V-1146)
Francisco Briceño
University of Cadiz, School of Medicine, Hospital Univ. Puerto Real
Cadiz, Spain
Phone: [phone]
francisco.***@****

Hepatitis C virus not only infects the liver but, several other cells in the body (i.e: white cells like the lymphocytes). This is the reason why people with chronic infection by the hepatitis C virus have numerous complications, other than liver disease. Chronic arthritis with inflammation of the joints is one of the numerous complications of chronic hepatitis C virus infection.

We have demosntrated that, patients first coming to their doctors for a chronic arthritis with inflammation have a higher chance to be infected by the Hepatitis C virus than people with degenerative arthritis (osteoarthritis, gout,..) or healthy persons (blood donors).

Thus, patients presenting with chronic inflammatory arthritis should be screened for Hepatitis C virus infection.

Previous reports have indicated that people with chronic hepatitis C virus infection have an increased chance of developping chronic arthritis with inflammation of the joints. The treatment commonly used for chronic inflammatory arhritis may adversely affect liver function in these patients with chronic liver disease due to the hepatitis C virus. Several authors reccomended that people with arthritis should be screened for hepatitis C virus infection. Nevertheless, the real burden of hepatitis C virus infection in patients first presenting with a chronic arthrtis of the peripheral joints (non spinal joints), is presently unknown.

Several years ago we frequently wondered whether hepatitis C virus infection could be associated to the condition of our patients presenting with a chronic peripheral arthritis. Therefore, we designed the present study that, compares the frequency of hepatitis C virus infection in patients presentig with a chronic arthritis of the peripheral joints with that in persons with degenerative arthritis (osteoarthritis), cristal induced arthritis (i.e.: gout) or healthy people (blood donors).

The results of this 4 year study are presented at the 44th ICAAC Meeting (Washington DC). These results show that persons presenting with a chronic arthritis with inflammation of the peripheral joints have an increased frequency of chronic hepatitis C virus infection than that of healthy people (blood donors). Many of these patients fulfill diagnostic criteria for other inflammatory rheumatic diseases (Rheumatoid arthritis, Systemic lupus erythematosus, Sjögren’s syndrome). Treating these patients with the drugs commonly used for those diseases could adversely affects their already damaged liver function. The best treatment for this patients would be a combination of the treatment for chronic hepatitis C virus infection (PEG-interferon + Ribavirin) plus any of the treatments for their chronic arthritis. Many times these patients having a peripheral chronic inflammatory arhtritis associated with hepatitis C virus infection, improve just with the treatment against the hepatitis C virus.

We do not presently know whether these chronic peripheral arhritis occur as a random association or as a consequence of an underlying chronic hepatitis C virus infection. To answer this question, we are assessing the influence of the treatment of chronic hepatitis C virus infection with PEG-Interferon plus Ribavirin in the clinical course of the chronic inflammatory arhritis.

[CMcH]

When I first complained of joint pain the docs thought it was menopause. Then it started getting more difficult to use my hands and I remembered that when I was trail running I found a tick on me and there was a sore red rash for days. I went to my family physician and asked for a blood  test for Lime disease and Lupus, because my mother has it. I was surprised when they found RA factor in my blood, no family HX of that. After waiting 3 months  to see the Rheumatologist he saw in my chart that I had HCV and didn't even look at my XRAY's told me it was the hep C. Now this is one of the main reasons I want to treat is that I need my hands, wrists, elbows, hips, ankles and knee's back. I used to run 6 days a week and take dance class 3 days a week. I'm doing all that a lot less now with great effort and incredible stiffness. I know TX can make the RA worse but I would like to hear from anyone that it got better post TX.
Dancegirl54, Do you know when and how you passed the virus to your kids? I have twins and hope they never get it. It is interesting that the virus has done more damage to your son than yourself.

[CMcH]

When I first complained of joint pain the docs thought it was menopause. Then it started getting more difficult to use my hands and I remembered that when I was trail running I found a tick on me and there was a sore red rash for days. I went to my family physician and asked for a blood  test for Lime disease and Lupus, because my mother has it. I was surprised when they found RA factor in my blood, no family HX of that. After waiting 3 months  to see the Rheumatologist he saw in my chart that I had HCV and didn't even look at my XRAY's told me it was the hep C. Now this is one of the main reasons I want to treat is that I need my hands, wrists, elbows, hips, ankles and knee's back. I used to run 6 days a week and take dance class 3 days a week. I'm doing all that a lot less now with great effort and incredible stiffness. I know TX can make the RA worse but I would like to hear from anyone that it got better post TX.
Dancegirl54, Do you know when and how you passed the virus to your kids? I have twins and hope they never get it. It is interesting that the virus has done more damage to your son than yourself.

[HARRYBEADS]

It seems that Doctors have a hard time admitting the connection, for years prior to diagnoses I have been suffering from extreme ankle and knee pain and finally a neurologist suggested being screened for hep c. He said anyone that has unexplained arthritic symptoms should be tested for Hep c.
Three other specialist diagnosed me with RSD prior to him.
The Hep Doctor says that if treatment works and the symptoms go away then it was connected.
  I think that some Doctors are afraid to say they don't know, they are not gods just good at booklearnin and if it aint in the book then Bobs your uncle.


Harry

[dancegirl54]

I have arthritis! Prior to my HCV diagnosis my rheumy diagnosed me with lupus - dr A says I do not have lupus, it is the HCV.  He says lots of HCV folks have carpal tunnel as well.  Lots of vague fibromyalgia/arthritic type symptoms.  Just be careful with the herbs - I was on a remedy that shot my ast/alts up a few years back. Diet, mild exercise and HR's regimen really has helped the arthitis as well as the HCV I hope

[Bobby1952]

My RH factor is high and I had some Shoulder pain a few years ago from it. Yes I heard it is a auto immune reaction to the hep c. I got rid of the pain by taking some chinese hebs that regulate your immune system.

Bobby

[reddawg]

Rheumatoid Arthritis is common with HepC. I had it in my elbows, knees. But it went away on iy's own after two months.

[Jack57]

I am set up for my liver biopsy next Sunday, so I haven't been through it yet. Their is some good info I got on the other Forum Hepatitis Comumity. Check it out. As for my Hip arthritis, I have been in pain for 3 years

[ginny6]

i have been diagnosed with chronic hepatitis b and also experience joint pain the rhuematism test came back a low positive and my knees are filling with fluid and hurt to stand up and down and throb and i also have other joint pain i am assuming this is caused by the hepatitis b the rhuematologist said it could be but wasn;t sure. whats up with you? do you have hep b?  i need the liver biopsy as well i was told i have an 8mm tumor and that it was probably a hemangioma. do you thing i should trust this?  what is the liver bioposy like? are you sedated? does it hurt?