Managing hepatitis C with joint pain, rheumatoid arthritis, and arthralgia

By: Emily Lunardo | Liver | Sunday, December 11, 2016 - 05:30 AM

Managing hepatitis C with joint pain, rheumatoid arthritis, and arthralgiaHepatitis C virus (HCV) infection has been found to cause rheumatoid arthritis (RA), even before HCV is detected. Hepatitis C can contribute to liver failure, but is also known to cause rheumatoid arthritis – inflammation of the joints. Due to the link between HCV and rheumatoid conditions, it’s important that newly diagnosed RA patients get tested for HCV, as rheumatoid symptoms can occur before HCV is even detected.

Rheumatoid diseases cause pain in the joints, muscles, and connective tissue. Joint swelling and blood vessel inflammation can occur as well. A recent study dove deeper into the connection between HCV and rheumatoid arthritis and uncovered what may link the two.

Hepatitis C virus infection linked with rheumatoid arthritis: Study

In a study published in PLoS One, researchers assessed the risk of rheumatoid arthritis in patients with HCV. Patients were studied from Taiwan, which has high rates of HCV, hepatitis B virus, and rheumatoid arthritis. Data was collected from one million patients and 249,460 patients were selected for analysis. The number of patients diagnosed with chronic hepatitis was 49,892.

Hepatitis C patients were compared with 199,568 controls who did not have HCV, matched by age, sex, and calendar year. Patients did not have rheumatoid arthritis at the beginning of the study, but cases were documented as they were diagnosed throughout the course of the study.

The researchers found that chronic infection with HCV was linked to higher incidences of rheumatoid arthritis. Men were more likely to develop rheumatoid arthritis with HCV, compared to women. Lastly, those with hepatitis C and B were at an even greater risk for rheumatoid arthritis, compared to those who had either one.

Arthralgia – a common symptom of HCV

Arthralgia – pain in a joint – is a common symptom of HCV, but can often be confused with rheumatoid arthritis. If arthralgia is mistaken for rheumatoid arthritis, it can lead to liver toxicity from RA prescription drugs, so distinguishing between the two is essential. In one study, it was found that 20 percent of HCV patients suffer from arthralgia.

Although it is still unclear how exactly HCV causes rheumatoid arthritis, some processes may reveal the connection. For starters, HCV may directly invade the synovial tissue, triggering an autoimmune response from the synovium, and then immune complex or cryoglobulin (a protein found in certain diseases) is deposited.

Because rheumatoid arthritis and HCV-related arthritis can present themselves so similarly, it can be quite difficult to distinguish between the two diseases. Anti-CPP antibodies are used as a marker to distinguish between the diseases. High levels of these antibodies are indicative of rheumatoid arthritis rather than HCV-related arthritis.

Prevention of hepatitis C and joint pain

To prevent joint pain and arthritis associated with hepatitis C, it’s essential to prevent hepatitis C. Prevention methods for hepatitis C include:

  • Practice safe sex – coming into sexual contact with someone who has HCV is not safe.
  • Do not share needles or use illicit injectable drugs.
  • Get yourself screened if you received blood transfusions prior to 1992 as there was suspicion of the virus being transmitted during that time.
  • Get yourself screened if you use needles, have a tattoo, or work in a healthcare field where you are exposed to blood samples or needles.

Treatment, diagnosis of hepatitis C and joint pain

To properly treat joint pain and hepatitis C, your rheumatologist and family doctor should work together to provide the best treatment for both conditions. Medications may interact and complications may arise, so having a strong relationship and communication between the two doctors can ease any potential complications.

To treat hepatitis C specifically, a combination of antiviral and interferon drugs may be used. Protease inhibitors, too, were recently discovered to be effective treatment options for those with HCV and may help shorten treatment time, which is normally quite lengthy.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to treat joint pain and inflammation caused by HCV. It’s important to know that many medications commonly used to treat rheumatoid arthritis may pose a risk to the liver in those with HCV, another reason why it is essential that your liver specialist and rheumatologist work together closely.

Diagnosis may be challenging as HCV may be symptomless for quite some time, and HCV-related arthritis can appear quite similar to rheumatoid arthritis. Uncovering antibodies in blood serum and running a series of blood tests can better help diagnose HCV and rheumatoid arthritis.

If you have been diagnosed with rheumatoid arthritis or are experiencing joint pain, you may want to have yourself checked for possible hepatitis C. It could end up being the underlying cause.

Safety precautions for hepatitis C patients

When treating arthritis in hepatitis C, patients can use hot or cold therapy but there are some precautions to keep in mind.

These include:

  • Heat offers relaxation, which is good for softening stiff and tense muscles and improving circulation.
  • Ice can be used for cooling purposes when the pain is causing a burning sensation.
  • Always ensure temperatures are not too hot to prevent burning, and never apply heat to cuts or scrapes.
  • Hot or cold packs should only be applied for 20 minutes or less.
  • If unsure, seek the guidance from a healthcare professional.

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Related Reading:

Hepatitis C infection in liver cirrhosis patients can be cured with investigational oral therapy

Hepatitis C screening recommended for baby boomers as they face higher viral infection risk

Sources:

http://www.hepatitiscentral.com/news/arthritis_advic/
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/HCV-Rheumatic-Diseases
http://www.gastroenterologyandhepatology.net/files/2014/06/gh0514_gurakar1.pdf
http://www.the-rheumatologist.org/article/hepatitis-c-virus-infection-associated-with-rheumatoid-arthritis/?singlepage=1

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