Priority Healthcare Pharmacy E-Health Services Hepatitis C – Frequently Asked Questions
CONDITIONS ASSOCIATED WITH HCV INFECTION AND TREATMENT Fatigue Right-Side Pain Loss of Libido Nausea Brain Fog (Confusion/Forgetfulness) Itching / Rash Vision Problems Depression Cryoglobulinemia Thyroid Problems Rheumatoid Arthritis-Like Symptoms Fibromyalgia Jaundice Ascites Portal Hypertension / Esophageal Varices Encephalopathy Fatigue (top) Fatigue, a feeling of tiredness or of having no energy, may be the only symptom of hepatitis C infection that some people have. Fatigue is both as symptom of HCV infection and a side effect of HCV medication. Right-Side Pain (top) The liver itself is relatively insensitive to pain, but it is enclosed by a fibrous capsule which extremely sensitive to stretching. When the liver swells as a result of infection, it stretches this capsule and causes pain. Note that there may be many other causes of pain in this area and that pain should be investigated by your physician. Loss of Libido (top) Loss of libido, or sex drive, is a complex problem. It may be due to the actual HCV infection, medication side effects, depression (which may or may not be associated with HCV medications), irritability, anxiety, stress, fatigue, fear, changes in body image or self-perception, or many other factors. If loss of interest in sex is a persistent and significant problem for you, you should be evaluated by your physician. Nausea (top) Nausea is a common side effect of HCV medications. Persistent nausea and vomiting is a serious concern and you should be evaluated by your doctor immediately. There are many medications available to manage nausea and vomiting. Brain Fog (Confusion/Forgetfulness) (top)
Priority Healthcare Pharmacy E-Health Services Hepatitis C – Frequently Asked Questions
Loss of concentration and decreased mental acuity is a common side effect of HCV medications and may be related directly to HCV infection. There is no specific remedy, but adequate selfcare, hydration, elimination of caffeine and mild exercise may help. Itching / Rash (top) Rash is very common with the ribavirin, but good skin care can improve it markedly. Speak with your doctor about your rash. Rashes & itch can be treated with topical steroid creams and oral antihistamines. Usually between these two agents rashes can be controlled if not eliminated entirely. Use sun screen everyday SPF 15 - 35 or greater, even if only to go out to the porch. Wear a hat with a large brim and light protective clothing such as a long sleeved cotton blouse or shirt, when going outside. Be sure you aren’t allergic to any of the products you are using. Itching may also be due to an accumulation of bilirubin in the skin. Actigall and Questran are two drugs reported to help with this problem. Vision Problems (top) Visual problems are a side effect of interferon medications. If you begin to notice changes in your vision, you should be evaluated by an Ophthalmologist as soon as possible. Some reports indicate that vision problems may improve after stopping medications for HCV infection, but this is not known for certain. Depression (top) Depression is one of the most serious side effects of HCV medications. If you have a history of depression prior to your HCV diagnosis, your doctor should send you to have a psychiatric evaluation prior to starting treatment and may prescribe antidepressant medication for you, even if you are not depressed at the moment. Serious depression, even suicide attempts have been seen in patients on interferon medications, so depression should be treated aggressively. Cryoglobulinemia (top) Cryoglobulins are proteins in the blood that clump together in the cold. Although this is a very rare condition, it appears to occur more often in HCV infection than in the general population. For these people, cryoglobulins can cause disease that affects any or all organs. When patients have symptoms as a result of these abnormal proteins, the disease is called "Cryoglobulinemia." The most common symptoms are those of weakness, joint pain, purple bruises, most commonly of the lower extremities. Besides the skin and joints, cryoglobulinemia can affect the nerves, kidneys, and liver. Thyroid Problems (top) Chronic hepatitis C infection is associated with many autoimmune diseases, in which the body develops an immune response to its own tissues. About 10% of people with chronic hepatitis C infection have antibodies to the thyroid gland.
Priority Healthcare Pharmacy E-Health Services Hepatitis C – Frequently Asked Questions
Some patients on HCV medications develop thyroid problems which may persist after discontinuation of therapy. This may include either hypothyroid (too low) or hyperthyroid (too high). Most thyroid conditions can be managed with medication. Rheumatoid Arthritis-Like Symptoms (top) Rheumatoid arthritis is an autoimmune disorder, and as mentioned above, people with HCV are prone to develop autoimmune disorders. Tests which check for rheumatoid arthritis sometimes are “false-positive” in HCV patients, indicating there is rheumatoid arthritis when in fact there is not. Additionally, some patient with Rheumatoid arthritis can test “false-positive” when testing for HCV antibodies. Fibromyalgia (top) Fibromyalgia is the name for a somewhat mysterious illness that is characterized by muscle and joint pain, extreme fatigue and unusual sensitivity to temperature. One study has suggested that there may be a relationship between HCV and fibromyalgia. (Journal of Clinical Rheumatology, Vol. 2, No. 4, August 1996). Jaundice (top) Jaundice is a yellow discoloration of the skin and eyes. It happens when a sick liver cannot remove a sufficient amount of bilirubin from the blood, and the excess bilirubin in the blood deposits in the skin and eyes. Ascites (top) Ascites is an abnormal accumulation of fluid in the abdominal cavity. This is caused by a deficient production of a protein called albumin by the liver. Although the fluid can be drained off by a procedure called a pericentesis, the fluid usually returns within a few days. Portal Hypertension / Esophageal Varices (top) Blood is carried through the liver by a blood vessel called the portal vein. In hepatitis, swelling of the liver can restrict the flow of blood. As blood flow is restricted, the pressure in the portal vein increases. This higher blood pressure in the portal vein is called portal hypertension. The blood flowing through the portal vein is trying to return to the heart, so when blood flow through the portal vein is restricted, blood has to find another route and return to the heart using other blood vessels. These vessels become swollen because of the increased amount of blood flowing through them. These swollen blood vessels are called varices (like varicose veins). These swollen blood vessels were not intended to carry high volumes of blood under high pressure, so they can become stretched. This stretching makes them very fragile and they can bleed easily. The esophagus is the tube that passes food from the mouth to the stomach. Varicies can develop in the esophagus, and the passage of food through the esophagus can cause these varices to bleed. Bleeding from a broken blood vessel is serious and can even be fatal.
Priority Healthcare Pharmacy E-Health Services Hepatitis C – Frequently Asked Questions
Hepatic Encephalopathy (top) Hepatic encephalopathy is a condition caused by abnormally high levels of ammonia in the blood. Ammonia is a normal by product of protein metabolism, but a sick liver often cannot remove it from the blood as fast as is necessary. High levels of ammonia begin to interfere with brain function, resulting in confusion, agitation, stupor and coma.