Fibromyalgia syndrome in chronic hepatitis C virus (HCV) infection patients: A potential association and pathogenic role

Autoantibodies and Rheumatologic Manifestations in Hepatitis C Virus Infection

“…Extra-hepatic manifestations of HCV infection are clinically present in forty to seventy percent of the patients [14][15][16][17], while rheumatologic manifestations have an incidence of 38% [18][19][20][21][22][23] (Table 1). These are mostly mediated by immunological mechanisms, rather than being related to the infection of extra-hepatic tissues [24].…”

“…Extra-hepatic manifestations of HCV infection are clinically present in forty to seventy percent of the patients [ 14 , 15 , 16 , 17 ], while rheumatologic manifestations have an incidence of 38% [ 18 , 19 , 20 , 21 , 22 , 23 ] ( Table 1 ).…”

“…In order to assess these unclear results, in 2021 Abdel Moatty A. Afifi et al tried to determine the frequency and the clinical characteristics of fibromyalgia in a cohort of Egyptian patients with chronic HCV; their study also tried to evaluate its relationship to viral load. Their results allowed to assess that, in these patients, fibromyalgia was actually associated with higher clinometric scores (Widespread pain index- WPI, symptom severity -SS, VAS-pain and points of tenderness) when compared to the control group in a statistically significant way; at the same time, the intensity of the condition was not related to the viral load of Hepatitis C Virus [ 18 ].…”

“…HCV infection is commonly associated with thyroid autoimmunity. Most of TAAb in chronic HCV carriers has been reported over the years, ranging between 4.5% and 25% [ 18 , 20 , 25 ]. The significant span in this range can be ascribed to the various methodological applications and the features of the analysed populations.…”

“…As illustrated by the literature, in the case of patients who were positive for TAAb before starting IFN-based treatments, such therapy for hepatitis C can lead to the production of TAAb or to a significant increase in TAAb levels. The development of TAAb as a consequence of IFN-based treatments ranges between 1.9% and 40.0% [ 18 , 20 , 24 , 25 ]. The literature highlights in particular the direct toxic effect of IFN on thyroid cells without the participation of immunological factors related to the HCV replication [ 24 ].…”