Musculoskeletal pain and fatigue are associated with chronic hepatitis C A report of 239 hepatology clinic patients

Barkhuizen, André; Rosen, Hugo R.; Wolf, Sara; Flora, Ken; Benner, Kent G.; Bennett, Robert M.

doi:10.1016/s0002-9270(99)00143-4

Cited by 82 publications

(78 citation statements)

References 35 publications

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“…Fatigue is generally the most frequently reported extrahepatic symptom in patients with CHC, although some researchers suggest that this fatigue is more closely related to depression severity than to hepatic disease itself. 6,8,15,33,35,36,49 Fatigue is reported to affect response to IFN-based therapy. 35 Maddock et al 64 used four self-report questionnaires to monitor side effects and HRQL in 29 patients with CHC and reported that patients experiencing severe fatigue were less likely to respond to therapy.…”

Section: Side Effects Of Chc Treatment and Their Managementmentioning

confidence: 99%

“…Fatigue was reported in 53% of patients and was disabling in 17%, 35 findings consistent with those of other studies in which the prevalence ranged from 50% to 67%. 6,8,15,33,35,36 Fatigue was also independently associated with age and female sex. Fatigue was not associated with viral factors.…”

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confidence: 92%

“…Fatigue is among the most frequent and disabling extrahepatic features of CHC. 33 Kramer et al 34 found significant fatigue in 120 untreated patients with CHC compared with healthy controls using the Fatigue Impact scale (49 versus 26 points) and the Brief Fatigue Inventory (3.0 versus 1.6 points; P Ͻ 0.001). In another study, Poynard et al 35 studied 1,614 patients with CHC to determine the association between fatigue and other clinical and biological extrahepatic manifestations of CHC.…”

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confidence: 99%

“…35 CHC patients have more systemic complaints of fatigue than patients with other types of chronic liver disease. 33 Barkhuizen et al 33 examined the frequency of fatigue in patients with CHC compared with other liver diseases. Fatigue was present in 66% of patients with isolated HCV infection compared with only 30% of patients with alcoholic liver disease and 29% with isolated hepatitis B virus infection.…”

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confidence: 99%

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The effects of HCV infection and management on health-related quality of life

2007

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confidence: 99%

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confidence: 92%

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confidence: 99%

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The effects of HCV infection and management on health-related quality of life

2007

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“…In conclusion, HCV infects brain microglia/macrophages and, to a lesser extent, astrocytes. Our findings could explain the biological basis of neurocognitive abnormalities in HCV infection.Patients with chronic hepatitis C virus (HCV) infection were reported to be more likely to manifest impairments in the quality of life, fatigue, and depression than patients with liver disease of other etiology (3,12,14,39). More recently, HCV infection was associated with cognitive dysfunction (11, 13).…”

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confidence: 99%

Hepatitis C Virus Neuroinvasion: Identification of Infected Cells

Wilkinson

Radkowski

Laskus

2009

J Virol

175

136

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Hepatitis C virus (HCV) infection often is associated with cognitive dysfunction and depression. HCV sequences and replicative forms were detected in autopsy brain tissue and cerebrospinal fluid from infected patients, suggesting direct neuroinvasion. However, the phenotype of cells harboring HCV in brain remains unclear. We studied autopsy brain tissue from 12 HCV-infected patients, 6 of whom were coinfected with human immunodeficiency virus. Cryostat sections of frontal cortex and subcortical white matter were stained with monoclonal antibodies specific for microglia/macrophages (CD68), oligodendrocytes (2,3-cyclic nucleotide 3-phosphodiesterase), astrocytes (glial fibrillary acidic protein [GFAP]), and neurons (neuronal-specific nuclear protein); separated by laser capture microscopy (LCM); and tested for the presence of positive-and negative-strand HCV RNA. Sections also were stained with antibodies to viral nonstructural protein 3 (NS3), separated by LCM, and phenotyped by real-time PCR. Finally, sections were double stained with antibodies specific for the cell phenotype and HCV NS3. HCV RNA was detected in CD68-positive cells in eight patients, and negative-strand HCV RNA, which is a viral replicative form, was found in three of these patients. HCV RNA also was found in astrocytes from three patients, but negative-strand RNA was not detected in these cells. In double immunostaining, 83 to 95% of cells positive for HCV NS3 also were CD68 positive, while 4 to 29% were GFAP positive. NS3-positive cells were negative for neuron and oligodendrocyte phenotypic markers. In conclusion, HCV infects brain microglia/macrophages and, to a lesser extent, astrocytes. Our findings could explain the biological basis of neurocognitive abnormalities in HCV infection.Patients with chronic hepatitis C virus (HCV) infection were reported to be more likely to manifest impairments in the quality of life, fatigue, and depression than patients with liver disease of other etiology (3,12,14,39). More recently, HCV infection was associated with cognitive dysfunction (11, 13). Importantly, Forton and colleagues, using proton magnetic resonance spectroscopy ( 1 H MRS), demonstrated elevations of choline/creatine ratios in basal ganglia and white matter in patients with mild hepatitis C disease that were not present in healthy volunteers or patients with hepatitis (9, 11). The presence of similar abnormalities consisting of increased choline and reduced N-acetyl aspartate levels among HCV-positive patients relative to those of controls has since been reported by other researchers (25, 41). The 1 H MRS changes in HCV infection are different from those seen in hepatic encephalopathy, where the choline ratios are depressed (40), but are similar to those found in patients with human immunodeficiency virus (HIV) infection (24, 26). Additional evidence for the biological basis of HCV-related cognitive dysfunction is provided by a recent report showing differences in gene expression patterns between brain tissue from HCV-positive and HCV-nega...

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