Fatigue in chronic hepatitis <scp>C</scp> infection: Understanding patients' experience from a cognitive‐behavioural perspective

Zalai, Dóra; Carney, Colleen E.; Sherman, Morris; Shapiro, Colin M.; McShane, Kelly

doi:10.1111/bjhp.12155

Cited by 10 publications

(7 citation statements)

References 40 publications

(55 reference statements)

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“…These include post-exertional malaise and an aversion to physical exercise/activity. They experience mental fatigue, sleep disruption, mood changes consistent with anxiety, depressive symptoms and decreased quality of life[62,63]. Some have difficulty concentrating and processing information.…”

Section: Mechanisms Of Fatiguementioning

confidence: 99%

Importance of fatigue and its measurement in chronic liver disease

Gerber¹,

Weinstein²,

Mehta³

et al. 2019

WJG

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The mechanisms of fatigue in the group of people with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are protean. The liver is central in the pathogenesis of fatigue because it uniquely regulates much of the storage, release and production of substrate for energy generation. It is exquisitely sensitive to the feedback controlling the uptake and release of these energy generation substrates. Metabolic contributors to fatigue, beginning with the uptake of substrate from the gut, the passage through the portal system to hepatic storage and release of energy to target organs (muscle and brain) are central to understanding fatigue in patients with chronic liver disease. Inflammation either causing or resulting from chronic liver disease contributes to fatigue, although inflammation has not been demonstrated to be causal. It is this unique combination of factors, the nexus of metabolic abnormality and the inflammatory burden of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis that creates pathways to different types of fatigue. Many use the terms central and peripheral fatigue. Central fatigue is characterized by a lack of self-motivation and can manifest both in physical and mental activities. Peripheral fatigue is classically manifested by neuromuscular dysfunction and muscle weakness. Therefore, the distinction is often seen as a difference between intention (central fatigue) versus ability (peripheral fatigue). New approaches to measuring fatigue include the use of objective measures as well as patient reported outcomes. These measures have improved the precision with which we are able to describe fatigue. The measures of fatigue severity and its impact on usual daily routines in this population have also been improved, and they are more generally accepted as reliable and sensitive. Several approaches to evaluating fatigue and developing endpoints for treatment have relied of biosignatures associated with fatigue. These have been used singly or in combination and include: physical performance measures, cognitive performance measures, mood/behavioral measures, brain imaging and serological measures. Treatment with non-pharmacological agents have been shown to be effective in symptom reduction, whereas pharmacological agents have not been shown effective.

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Section: Mechanisms Of Fatiguementioning

confidence: 99%

Importance of fatigue and its measurement in chronic liver disease

Gerber¹,

Weinstein²,

Mehta³

et al. 2019

WJG

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“…Fatigue is a common symptom in rheumatologic conditions such as rheumatoid arthritis (RA), ankylosing spondylitis, systemic sclerosis and systemic lupus erythematosus . There is an interaction between fatigue and mood disturbances, anemia, infections, fever, pain, smoking, sleep disturbances and stress . These interactions make it difficult to assess fatigue in chronic inflammatory diseases…”

Section: Introductionmentioning

confidence: 99%

Fatigue in patients with Behçet's syndrome: relationship with quality of life, depression, anxiety, disability and disease activity

et al. 2016

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“…To date, only three articles focused on the lived experience of HCV have used qualitative data collected during the interferon‐free DAA era. One of these articles focused exclusively on the Aboriginal community in Australia (Treloar et al., ), one on the experience of taking interferon‐free treatment (Whiteley, Whittaker, Elliott, & Cunningham‐Burley, ) and the other was limited to an examination of HCV‐related fatigue (Zalai et al., ). A broader contemporary understanding of how HCV is being experienced and perceived is therefore currently absent.…”

Section: Introductionmentioning

confidence: 99%

“…For over 15 years, recurrent qualitative investigation has illuminated how HCV is experienced, understood and constructed by those living with the virus. Studies commonly portray a disruptive and distressing phenomenon manifest in social, emotional and physical spheres of illness, with specific facets of experience such as diagnosis (Glacken, Kernohan, & Coates, 2001), fatigue (Glacken, Coates, Kernohan, & Hegarty, 2003;Zalai, Carney, Sherman, Shapiro, & McShane, 2016) and stigma (Butt, Paterson, & McGuinness, 2008;Fraser & Treloar, 2006) often emphasised. This body of work provides insight into how HCV is conceptualised by those it affects, exposing common expectations of chronic morbidity and altered life trajectories (Conrad, Garrett, Cooksley, Dunne, & MacDonald, 2006;Paterson, Butt, McGuinness, & Moffat, 2006;Sutton & Treloar, 2007).…”

Section: Introductionmentioning

confidence: 99%