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Symptoms of HCV/ Gen. Info, Associated Conditions

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  • claudine intexas
    http://www.hepu.org/articles/medisse.html WHAT ARE THE MAIN SYMPTOMS OF HEPATITIS C? Acute hepatitis C is almost indistinguishable from acute hepatitis B
    Message 1 of 1 , Nov 30, 2000
      http://www.hepu.org/articles/medisse.html

      WHAT ARE THE MAIN SYMPTOMS OF HEPATITIS C?
      Acute hepatitis C is almost indistinguishable from
      acute hepatitis B
      infection. Patients with
      acute hepatitis C are frequently asymptomatic (meaning
      that they have no
      symptoms), even when
      liver tests are abnormal. - "Hepatitis C & E: how much
      of a threat?" Special
      Issue: Emerging
      Infectious Diseases, Brown, Edwin A., May 15 1994,
      v28, n9, p105(8)

      Soon after contracting the infection many people have
      a flu-like illness with
      fatigue, fever,
      muscular aches and pain, nausea and vomiting. About
      10% of patients become
      jaundiced (their
      skin turns yellow). Generally these symptoms resolve
      and the patient has no
      symptoms of liver
      disease for many years. Symptoms may occur from two
      weeks to six months after
      exposure but
      usually within two months.


      What are the symptoms of chronic infection and
      cirrhosis? The symptoms of
      chronic infection
      range from no symptoms at all, to gradually
      progressive fatigue and lack of
      energy, to complete
      debility. The effects of the virus vary widely between
      individuals.

      The symptoms of cirrhosis include progressive fatigue,
      jaundice (yellow
      skin), icterus (yellow
      eyes), dark urine (the color of cola), abdominal
      swelling, muscle wasting,
      itching,
      disorientation and confusion, loss of appetite, and
      easy bruisability.

      ---
      In an informal survey of hepatitis C symptoms, Scott
      Warren
      <swarren@...> polled 50 people
      on the HEPV-L list and compiled the following results:


      FATIGUE, WEAKNESS, TIREDNESS - 72%
      JOINT, MUSCLE PAINS - 52%
      MEMORY LOSS, MENTAL CONFUSION - 50%
      SKIN PROBLEMS-DRY\ITCHY\RASHES\SPOTS - 44%
      DEPRESSION, ANXIETY, IRRITABILITY, ETC - 44%
      INDIGESTION, NAUSEA, VOMITING, GAS - 34%
      SLEEP DISTURBANCES - 32%
      PAIN OR DISCOMFORT IN ABDOMEN - 32%
      CHILLS, SWEATING, HOT \ COLD FLASHES - 26%
      EYE OR EYESIGHT PROBLEMS - 24%
      SENSITIVITY TO HEAT OR COLD - 22%
      NO SYMPTOMS - 20%
      VERTIGO, DIZZINESS, COORDINATION - 18%
      FLU LIKE SYMPTOMS - 18%
      HEADACHES - 18%
      URINARY PROBLEMS, ODOR, COLORATION - 16%
      FEVER - 16%
      SLOW HEALING AND RECOVERY - 14%
      SUCCEPTIBILITY TO ILLNESS \ FLU - 14%
      WEIGHT GAIN, WATER RETENTION - 10%
      MENSTRUAL PROBLEMS - 10%
      APPETITE \ WEIGHT LOSS - 8%
      SWELLING OF STOMACH, LEGS OR FEET - 8%
      ORAL, OR MOUTH SORES \ PROBLEMS - 8%
      EXCESSIVE BLEEDING - 4%

      FATIGUE
      The main symptom of most people with hepatitis C is
      chronic fatigue, ranging
      from simply getting
      tired easily to extreme, debilitating fatigue.

      UPPER RIGHT QUADRANT (URQ) PAIN (SIDE PAIN)
      Even though the liver itself contains no nerve
      endings, and does not feel
      pain, many people with
      HCV experience a pain on the upper right side of their
      body, just beneath the
      ribs. This is
      thought by some to be "referred pain" from the
      swelling of the liver capsule
      due to the disease
      process. This pain may also be referred to the right
      shoulder or to the back
      between the
      shoulder blades.

      LOSS OF LIBIDO
      Many hepatitis C patients find that they are no longer
      interested in sex.
      This tends to be
      especially true for those undergoing interferon
      treatment. This is not
      necessarily directly
      related to the hepatitis, but is most likely due to
      the stress, discomfort
      and exhaustion caused
      by the struggle with a chronic illness.

      RED PALMS
      Red palms can occur in any chronic liver disease and
      are not specifically
      caused by the virus.
      The cause for the redness is unknown, but it's
      speculated that it may involve
      upset hormone
      metabolism or microcirculatory changes.

      NAUSEA
      A few of the more popular nausea aids are chewing
      candied ginger, putting a
      (small) drop of peppermint oil on the end of your
      tongue, eating small
      frequent meals, dry crackers and weak tea, and
      popsicles.

      BRAIN FOG
      This is the mental fuzziness and forgetfulness that
      some people experience.
      It's not the same as encephalopathy, and seems to
      occur in all stages of the
      illness. Some people have found taking CoEnzyme Q10,
      also known as CoQ10, to
      be helpful (2 30mg capsules per day). Another
      listmember recommends taking
      Gingko Biloba.

      ITCHING
      The build-up of bilirubin in the skin may cause
      itching. Itching can be
      treated with antihistamines, or cholestyramine (which
      binds bile in the
      intestines). Actigall and Questran are two drugs
      reported to help with this
      problem.

      VISION PROBLEMS
      Some hepatitis patients complain of blurring vision,
      and dry eyes. This can
      be especially true while undergoing interferon
      treatment.

      DIZZINESS
      Some people have found that wearing "Sea Bands" helps
      with their dizziness.
      Sea Bands are elastic bands that can be bought,
      usually in sporting goods
      stores, which press against pressure points in the
      wrist. They were designed
      for use in seasickness.

      DRY MOUTH
      There are two products (mouthwash and toothpaste) by
      the name of Biotene,
      which are designed to help with the problem of a dry
      mouth and gum problems
      as a result of medication use. Several listmembers
      have reported great relief
      by using these products.

      IT'S NOT ALL IN YOUR HEAD!
      Some doctors (but thankfully fewer than there used to
      be) insist on believing
      that HCV usually has no symptoms, and dismiss the
      patient's complaints as
      being "all in their head". Some HCV+ patients have
      been treated for
      depression for many years before their actual
      diagnosis of HCV was uncovered.
      Much is still unknown about the hepatitis C virus, and
      many physicians have
      not had much experience treating it. Many doctors are
      not yet familiar with
      the research which legitimizes the various symptoms
      which go along with this
      virus.


      Emerging illnesses such as HCV typically go through a
      period of many years
      before they are accepted by the medical community, and
      during that interim
      time patients who have these new, unproven symptoms
      are all too often
      dismissed as being "psychiatric cases". This has been
      the experience with HCV
      as well.

      WHAT IS THE EVOLUTION OF THE DISEASE?
      Three out of four people infected with hepatitis C -
      not 50%, as once thought
      - will remain infected for life. Up to half of those
      people will develop
      cirrhosis, scarring of the liver, and up to 10,000
      will die this year, say
      doctors and disease trackers meeting in San Diego. The
      latest findings are
      sobering because about 1.4% of the U.S. population is
      infected with the virus
      - "Hepatitis C Chronic 75% of the Time", USA Today,
      05-15-1995

      ---
      At least 50-80% of people infected with HCV will
      develop chronic hepatitis;
      ultimately, 20-30% of those will progress to
      cirrhosis. Another 20-30% may
      develop chronic HCV infection without abnormal
      elevations of liver enzymes in
      the blood. - "Prevention, Diagnosis, and Management of
      Viral Hepatitis", AMA

      WHAT OTHER MEDICAL PROBLEMS CAN BE RELATED TO HCV?
      Chronic hepatitis C infection occasionally causes
      problems for parts of the
      body beyond the liver. The organs most often affected
      include the blood
      vessels, skin, joints, kidneys, and thyroid gland. If
      chronic hepatitis C
      infection causes liver cirrhosis (severe scarring of
      the liver rarely caused
      by hepatitis C), many problems may arise from the
      cirrhosis, per se.
      Potential problems from cirrhosis include fluid
      accumulation in the abdomen,
      bleeding into the stomach, jaundice, confusion, poor
      blood clotting, and
      susceptibility to infection.

      ---
      Hepatitis has so many symptoms that it's easy to
      ascribe all new anomalies to
      this disease. But HCV patients are not exempt from
      getting other illnesses
      also, therefore it is important to regularly monitor
      your health and to
      consult with your doctor about the changes as they
      progress.

      CRYOGLOBULINEMIA
      One-third to one-half of people with chronic hepatitis
      C infection have
      cryoglobulinemia (antibodies in the bloodstream
      attached to the hepatitis C
      RNA that happen to solidify when cold). Hepatitis C is
      recognized as the most
      common cause of mixed cryoglobulinemia. Most of the
      people with
      cryoglobulinemia from hepatitis C have had their
      hepatitis for a long time or
      have cirrhosis. People with higher concentrations of
      hepatitis C RNA in their
      blood do not seem to have a higher risk of having
      cryoglobulinemia. Usually
      the cryoglobulins are in low concentration and cause
      no symptoms. About
      twenty-percent of people with hepatitis C and
      cryoglobulinemia have symptoms.
      Symptoms most often associated with cryoglobulinemia
      include mild fatigue,
      joint pains, or itching.
      Occasionally, people with cryoglobulinemia develop
      vasculitis (inflammation
      of the blood vessels) which can cause purpura (purple
      skin lesions),
      Raynaud's phenomenon (the hands turn white, then blue,
      and then red from
      constriction and subsequent dilation of the blood
      vessels), or numbness in
      the hands and feet. The presence of cryoglobulinemia
      does not effect people's
      response to interferon. In fact, some people with
      vasculitis have improvement
      in the vasculitis as their liver tests improve on
      interferon.

      THYROID AND AUTOIMMUNE PROBLEMS
      Chronic hepatitis C infection is also associated with
      many autoimmune
      diseases (where the body develops antibodies which
      attack parts of itself).
      For example, about one-tenth of people with chronic
      hepatitis C infection
      (more often in women and older people) have antibodies
      to the thyroid gland,
      one-half of whom may develop hypothyroidism (an
      underactive thyroid gland).
      Additionally, interferon therapy causes hypothyroidism
      or hyperthyroidism (an
      overactive thyroid gland) in about one-tenth of those
      treated. People with
      hypothyroidism may suffer from fatigue poor memory,
      weakness, constipation,
      weight gain, muscle cramps, intolerance to cold,
      hoarse voice, coarse skin,
      and brittle hair. People with hyperthyroidism may
      suffer from anxiety,
      insomnia, weakness, diarrhea, weight loss, intolerance
      to heat, velvet-like
      skin, and brittle nails. Hypothyroidism can be treated
      with thyroid hormone
      pills. Hyperthyroidism can be treated with pills that
      block thyroid hormone
      synthesis. If the thyroid gland dysfunction is from
      interferon treatment and
      is caught early, the thyroid gland will return to
      normal once interferon is
      stopped.

      RHEUMATOID ARTHRITIS-LIKE SYMPTOMS
      Hepatitis C infection can present with rheumatic
      manifestations
      indistinguishable from rheumatoid arthritis. The
      predominant clinical
      findings include palmar tenosynovitis: small joint
      synovitis, and carpal
      tunnel syndrome. Risk factors such as transfusions and
      IV drug abuse or a
      history of hepatitis or jaundice should be included in
      the history of present
      illness of any patient with acute or chronic
      polyarthritis or unexplained
      positive RF. In such patients, gammaglutamyl
      aminotransferase, serologic
      studies for hepatitis C, and other tests appropriate
      for chronic liver
      disease should be performed. - " Journal of
      Rheumatology, June
      1996;23(6):979-983.

      FIBROMYALGIA
      Fibromyalgia is the name for a condition that
      typically includes widespread
      muscle pain, fatigue and abnormal sleep patterns.
      Until a few years ago,
      doctors called the condition fibrositis or muscular
      rheumatism and believed
      that for the most part, the condition was "all in the
      patient's head". Today,
      fibromyalgia is recognized by medical organizations as
      a genuine and serious
      problem.
      The symptoms of fibromyalgia typically include pain in
      many muscles, and
      around ligaments and tendons, persistent fatigue,
      waking up feeling tired
      even after a full night's sleep, headaches, bouts of
      constipation and
      diarrhea, abdominal pain, painful menstrual periods,
      sensitivity to cold,
      numbness or tingling, and difficulty exercising.
      Symptoms vary widely among patients and tend to wax
      and wane over time. An
      illness, injury, cold weather or emotional stress may
      trigger a fibromyalgia
      episode or make ongoing symptoms worse.
      A study at the Oregon Health Sciences University and
      Portland Adventist
      Hospital suggests hepatitis C may trigger fibromyalgia
      ("Fibromyalgia: A
      prominent feature in patients with musculoskeletal
      problems in chronic
      hepatitis C, A report of 12 patients," by A.
      Barkhuizen, G.S. Schoepflin, and
      R.M. Bennett, Journal of Clinical Rheumatology, Vol.
      2, No. 4, August 1996) .
      This study is the first to show a link between the two
      illnesses.It was
      determined that the between the hepatitis C virus and
      fibromyalgia followed
      three distinct patterns:In nine patients, fibromyalgia
      developed as a
      long-term complication of the hepatitis, arising on
      average 13.4 years after
      the virus was acquired.In two patients, fibromyalgia
      arose simultaneously
      with the hepatitis C infection.In one patient,
      pre-existing fibromyalgia was
      significantly worsened by the hepatitis C. It is
      unknown why the hepatitis C
      virus and fibromyalgia may be linked, but the authors
      suggest that hepatitis
      C causes chronic activation of the immune system that
      leads to muscle aching,
      fatigue, mental changes, sleep abnormalities, and
      alterations of the
      neuroendocrine system.The patients with both hepatitis
      C and fibromyalgia
      could be distinguished from most other patients with
      fibromyalgia alone
      because they had symptoms unusual to fibromyalgia.
      These symptoms included
      synovitis (inflammation of the membrane around a
      joint, bursa, or tendon) and
      vasculitis (inflammation of a blood or lymph vessel).
      In addition, laboratory
      findings pointed to a disease process other than
      fibromyalgia.

      DERMATOLOGICAL MANIFESTATIONS
      The main dermatologic disorders in HCV infection
      include (1) vasculitis
      (mainly cryoglobulin-associated vasculitis, the cause
      of which is HCV in most
      cases, and, possibly, some cases of polyarteritis
      nodosa); (2) sporadic
      porphyria cutanea tarda; (3) cutaneous and/or mucosal
      lichen planus; and (4)
      salivary gland lesions, characterized by lymphocytic
      capillaritis, sometimes
      associated with lymphocytic sialadenitis resembling
      that of Sjoegren's
      syndrome.
      Hepatitis C virus is the cause of, or is associated
      with, various
      dermatologic disorders. In patients with such
      disorders, HCV infection must
      be sought routinely because antiviral therapy may be
      beneficial in some of
      them. - Arch Dermatol. 1995; 131:1185-1193

      PORPHYRIA CUTANEA TARDA (PCT)
      Porphyrins are a group of compounds that are mainly
      synthesized in the bone
      marrow. They play an important role in many chemical
      reactions in the body,
      e.g. with proteins to build hemoglobin. They are later
      converted to bile
      pigments mainly in the liver. Porphyrinuria increase
      of porphyrins in the
      urine) may be caused by chronic liver diseases.
      Hepatitis C is a major cause
      of porphyria throughout the world and may cause many
      symptoms, including
      excess blood iron - important in conjunction with an
      interferon therapy
      (since elevated blood iron seems to reduce the effect
      of interferon).
      Porphyria cutanea tarda is a rare deficiency of a
      liver enzyme essential for
      cellular metabolism. The enzyme deficiency may cause
      sun exposed skin to
      blister, ulcerate, turn dark, or bruise. Hair may
      increase on the forehead,
      cheeks, or forearms, and the urine may turn pink or
      brown. It now appears
      that hepatitis C is the most common trigger of
      porphyria in people who are
      predisposed. Topical sunscreens do not prevent the
      skin lesions. Avoidance of
      alcohol and removal of iron by repeated phlebotomy
      (blood removal) or taking
      medication that binds to iron sometimes helps.
      Chloroquine (an anti-malaria
      drug), which removes a toxic by-product of the enzyme
      deficiency, may help,
      as well.

      LICHEN PLANUS
      Occasionally, people with chronic hepatitis C develop
      a skin condition called
      lichen planus. It is a grouping of small, itchy,
      irregular, flat-topped
      reddened bumps. The bumps often have a network of very
      fine gray lines on
      their tops. The bumps show up most often on the
      wrists, shins, lower back, or
      genitals. Lichen planus also frequently occurs in the
      mouth, where it looks
      like a white, net-like plaque. It sometimes shows up
      as mouth ulcers and can
      be treated with a steroid mouth rinse called
      Dexamethasone Elixir or Nystatin
      tablets.

      CYCLES AND FLAREUPS
      Hepatitis flareups tend to occur in cycles, where for
      a while you may feel
      pretty good, then bad (maybe days to weeks for each
      period), then good again.
      It can be frustrating to obtain some relief, but then
      not know whether you
      have recovered or if you are merely between cycles.
      Some people claim that they begin to feel better in
      the Spring, then start to
      feel worse again in August/September, with a low point
      usually around
      November/December.


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