Many experts believe that viral infections can trigger the onset of fibromyalgia. The Epstein-Barr virus, Herpes Simplex Virus, and hepatitis B and C have all been implicated in the development of fibromyalgia. Chronic hepatitis C in particular shares many of the same symptoms as fibromyalgia. In this post, I will explain how chronic hepatitis C is linked to fibromyalgia and why hepatitis C may trigger the onset of fibromyalgia.
Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). It is a blood-born virus that is spread when the blood from an infected person enters the bloodstream of someone who is not infected. Before widespread screening of the blood supply in 1992, HCV was spread through blood transfusions and organ transplants. Today, most people become infected by sharing needles and other equipment for injecting drugs
Acute hepatitis C refers to the first few months after someone is infected. About 20 percent of people are able to clear the virus within the first 6 months. The other 80 percent of people who get infected are not able to clear the virus and develop a chronic or lifelong infection. Over time, chronic hepatitis C can cause serious health problems including liver disease, liver failure, and even liver cancer.
Many people with hepatitis C do not know they are infected because they have no symptoms. They can live with HCV for decades without feeling sick. While anyone can get hepatitis C, over 75 percent of those infected are baby boomers (people born between 1945-1965). The only way to know if you have chronic hepatitis C is to get tested. In fact, the Center for Disease Control and Prevention (CDC) recommends that all baby boomers should get tested for hepatitis C.
Chronic Hepatitis C and Fibromyalgia
A surprising number of people who have been diagnosed with chronic hepatitis C have also been diagnosed with fibromyalgia. In one study the prevalence of fibromyalgia in people with chronic hepatitis C (15 – 19 percent) was found to be much higher than the occurrence of fibromyalgia in the American population (2 percent). This suggests that chronic hepatitis C may indeed act as a trigger to the onset of fibromyalgia.
The documented links between the two conditions include:
- Symptom Specificity – Fibromyalgia and chronic hepatitis C infection share many clinical features including musculoskeletal pain and fatigue. While the two conditions do not always accompany each other, some symptoms may be unique when a person has both fibromyalgia and hepatitis C. One study found that people who are diagnosed with both fibromyalgia and hepatitis C exhibit symptoms such as inflammation around a joint, bursa (a fluid filled sac around tissues) and/or tendon, and vasculitis (blood or lymph vessel inflammation). This inflammation is not seen in hepatitis C negative people with fibromyalgia.
- Immune Proteins – Cytokines are proteins that regulate the immune response. Interleukins are a specific type of cytokine that causes a person to feel pain. Several interleukins have been found to be dramatically elevated in fibromyalgia patients. Harvard researchers found those same interleukins increased in production when exposed to the hepatitis C virus.
- Hepatitis C and Pain – Many people infected with hepatitis C complain of myalgias, arthritis, and widespread pain. When compared to other liver diseases, the frequency of musculoskeletal pain clearly favors hepatitis C. The frequencies of musculoskeletal pain for Alcoholic liver disease is 48 percent, Hepatitis B is 59 percent and Hepatitis C is 91 percent. As fibromyalgia’s most prominent symptom, it is not surprising that musculoskeletal pain may represent the link to Hepatitis C.
Besides fatigue and widespread pain, other symptoms of chronic hepatitis C include:
- Brain fog (confusion, memory loss, sudden blankness)
- Digestive problems/nausea
- Mood swings
- Un-refreshing sleep
- Night sweats
- Liver pain/discomfort
- Skin problems (itching, rashes, dermatitis)
- Flu like symptoms (headache, chills, fever)
- Vision problems
As you can see, chronic hepatitis C and fibromyalgia have many symptoms in common. An article published in The American Medical Association Journal of Ethics, Symptoms, Diagnosis, and Treatment of Fibromyalgia, recommends screening for hepatitis C when risk factors are present or hepatic enzymes are elevated.
Why Chronic Hepatitis C Is Called A Silent Epidemic
Chronic hepatitis C is called a “silent epidemic” because millions of people are believed to be infected and shockingly many don’t even know it. Because hepatitis C usually produces no symptoms or very mild flu-like symptoms during the early stages, many people don’t know they have it until liver damage shows up. Most people find out decades later during routine medical tests.
I was diagnosed with chronic hepatitis C in 2000. I went in for routine pre-op blood tests and my liver enzymes were high. Surgery was postponed and after more blood tests I was told I had chronic hepatitis C. I was shocked because the risk factors didn’t apply to me. No drug use, no tattoos and no blood transfusions.
If you have seen that commercial about HCV treatment, it starts out with “How did I get this disease?” After I was diagnosed that question about drove me crazy. I was hospitalized when I was 12 for extreme fatigue and flu-like symptoms. Blood tests at the time showed something but they didn’t know what. I was even told I should never donate blood. I guess it is a real possibility that is when I was first infected.
Chronic Hepatitis C Treatment
When I went through treatment in 2002, treatment for HCV consisted of a combination of Interferon and Ribavirin. Interferon was a weekly injection and Ribavirin was a daily pill. Thanks to this combo, the cure rate jumped from less than 5% to about 50% by the early 2000s. But interferon and ribavirin have terrible side effects, including muscle aches, fever, nausea, anxiety, depression, cognitive confusion, and trouble sleeping. You also need to take them for up to 48 weeks to see results.
Treatment was pure hell. I experienced severe muscle pain, mental confusion, anxiety, and extreme mood swings. Luckily, I could sleep and I did, for days at a time. I had to force myself to eat and I was told I had to drink a gallon of water every day. The treatment was so toxic I was sure I was going to die. Although the treatment worked, symptoms of fatigue, pain, and brain fog never went away. Eventually, I was diagnosed with fibromyalgia.
The Hepatitis C Trust held a web-based survey from April 2006 to September 2007 that asked about people’s experience of hepatitis C treatment and in particular how they felt up to 3 years after finishing the treatment. 500 respondents completed the questionnaire. 90% reported ongoing symptoms/side effects for longer than 12 months after treatment ended. The five most frequently reported post-treatment symptoms/side effects were fatigue, joint aches/pains, brain fog, depression and mood swings. And regardless of the outcome of treatment, 40% of people felt worse after treatment than before.
Since then, researchers have made significant advances in treatment for hepatitis C. As a result, people experience better outcomes, fewer side effects and shorter treatment times — some as short as 12 weeks. Treatment regimens may vary depending on the hepatitis C genotype, presence of existing liver damage, other medical conditions, and prior treatments. Generally, treatments are much more effective today with cure rates of nearly 100 percent. The downside is these new hepatitis C treatments can cost over $100,000 and insurance companies could balk at covering the cost.
Even though I have been successfully treated for chronic hepatitis C, my doctors are very careful about prescribing medications that are hard on the liver or can potentially cause liver toxicity. If you think you might have hepatitis C, please get tested -especially if you are over the age of 50.
Have you been diagnosed with both chronic hepatitis C and fibromyalgia?