2.2.2 What Are the Main Symptoms of HCV?
Acute hepatitis C is almost indistinguishable from acute hepatitis B infection. Patients with acute hepatitis C are frequently asymptomatic (meaning that they have no symptoms), even when liver tests are abnormal. - “Hepatitis C & E: how much of a threat?” Special Issue: Emerging Infectious Diseases, Brown, Edwin A., May 15 1994, v28, n9, p105(8).
Soon after contracting the infection many people have a flu-like illness with fatigue, fever, muscular aches and pain, nausea and vomiting. About 10% of patients become jaundiced (their skin turns yellow). Generally these symptoms resolve and the patient has no symptoms of liver disease for many years. Symptoms may occur from two weeks to six months after exposure but usually within two months.
The symptoms of chronic infection range from no symptoms at all, to gradually progressive fatigue and lack of energy, to complete debility. The effects of the virus vary widely between individuals.
The symptoms of cirrhosis include progressive fatigue, jaundice (yellow skin), icterus (yellow eyes), dark urine (the color of cola), abdominal swelling, muscle wasting, itching, disorientation and confusion, loss of appetite, and easy bruisability.
In an informal survey of hepatitis C symptoms, Scott Warren email@example.com polled 50 people on the HEPV-L list and compiled the following results:
- FATIGUE, WEAKNESS, TIREDNESS - 72%
- JOINT, MUSCLE PAINS - 52%
- MEMORY LOSS, MENTAL CONFUSION - 50%
- SKIN PROBLEMS-DRY\ITCHY\RASHES\SPOTS - 44%
- DEPRESSION, ANXIETY, IRRITABILITY, ETC - 44%
- INDIGESTION, NAUSEA, VOMITING, GAS - 34%
- SLEEP DISTURBANCES - 32%
- PAIN OR DISCOMFORT IN ABDOMEN - 32%
- CHILLS, SWEATING, HOT \ COLD FLASHES - 26%
- EYE OR EYESIGHT PROBLEMS - 24%
- SENSITIVITY TO HEAT OR COLD - 22%
- VERTIGO, DIZZINESS, COORDINATION - 18%
- FLU LIKE SYMPTOMS - 18%
- HEADACHES - 18%
- URINARY PROBLEMS, ODOR, COLORATION - 16%
- FEVER - 16%
- SLOW HEALING AND RECOVERY - 14%
- SUSCEPTIBLENESS TO ILLNESS \ FLU - 14%
- WEIGHT GAIN, WATER RETENTION - 10%
- MENSTRUAL PROBLEMS - 10%
- APPETITE \ WEIGHT LOSS - 8%
- SWELLING OF STOMACH, LEGS OR FEET - 8%
- ORAL, OR MOUTH SORES \ PROBLEMS - 8%
- EXCESSIVE BLEEDING - 4%
- NO SYMPTOMS - 20%
The main symptom of most people with hepatitis C is chronic fatigue, ranging from simply getting tired easily to extreme, debilitating fatigue. The fatigue is often not recognized as such. Many people suffering from this “fatigue” do not have a desire to sleep because they are tired. Rather, they are suffering a very low level muscle pain (which often they do not recognize) that just wears them down. Taking a nap really helps. “It took me years to figure out that it was pain. When nurses would say to me, “You look tired”, I wouldn’t know what they meant. I did not always want to go to sleep. Now much of that has changed. I do get sleepy-tired and must nap often.” (squeeky).
A study by Goh J, Coughlan B, Quinn J, O'Keane JC, Crowe J Department of Hepatology, Mater Misericordiae Hospital and University College Dublin, Ireland found that fatigue does not correlate with the degree of hepatitis or the presence of autoimmune disorders in chronic hepatitis C infection. The doctors concluded that the perceived functional impact of fatigue on quality of life is significantly higher in patients with chronic HCV genotype 1b infection compared to healthy controls. However, it is unrelated to the degree of hepatitis and cannot be accounted for by the co-existence of autoimmune disorders alone. Eur J Gastroenterol Hepatol 1999 Aug;11(8):833-8
Even though the liver itself contains no nerve endings, and does not feel pain, many people with HCV experience a pain on the upper right side of their body, just beneath the ribs. It varies from a dull ache and bruised feeling, to sharp stabbing pain which is quite different from “gas pains.”
This is thought by some to be “referred pain” from the swelling of the liver capsule due to the disease process. This pain may also be referred to the right shoulder or to the back between the shoulder blades.
Many hepatitis C patients find that they are no longer interested in sex. This tends to be especially true for those undergoing interferon treatments. This is not necessarily directly related to the hepatitis, but is most likely due to the stress, discomfort and exhaustion caused by the struggle with a chronic illness.
Red palms can occur in any chronic liver disease and are not specifically caused by the virus. The cause for the redness is unknown, but it’s speculated that it may involve upset hormone metabolism or microcirculatory changes.
A few of the more popular nausea remedies are chewing candied ginger, putting a (small) drop of peppermint oil on the end of your tongue, eating small frequent meals, dry crackers and weak tea, and sucking on popsicles. Sometimes the nausea is caused by disturbances to the inner ear, in which case your doctor might be able to prescribe treatment. Many persons on the list have developed autoimmune inner ear disease as a complication of hepatitis C.
This is the mental fuzziness and forgetfulness that some people experience. It’s not the same as encephalopathy, and seems to occur in all stages of the illness. Some people have found taking CoEnzyme Q10, also known as CoQ10, to be helpful (two 30 mg capsules per day). Another listmember recommends taking Gingko Biloba.
The build-up of bilirubin in the skin may cause itching.
Itching can be treated with antihistamines, or cholestyramine (which binds bile in the intestines). Actigall and Questran are two drugs reported to help with this problem.
Recently many of our members have taken to using “bag balm,” an antibacterial ointment used on cow’s udders. It is apparently effective and harmless. It can be obtained from any equestrian or farm supply store, and sometimes in the better pharmacies.
Some hepatitis patients complain of blurring vision, and dry eyes. This can be especially true while undergoing interferon treatment. Interferon treatment can and does trigger retinal complications in some people, such as hemorrhages, as well as vitreous detachments, cotton wool spots, cataracts and even strokes (infarcts). Be sure to get your eyes tested before beginning treatment. There are products to counteract dry eyes. If you are on treatment, use sunglasses outdoors
Some people have found that wearing “Sea Bands” helps with their dizziness. Sea Bands are elastic bands that can be bought, usually in sporting goods stores, which press against pressure points in the wrist. They were designed for use in seasickness.
Hepatitis C is becoming increasingly associated with a host of autoimmune disorders. Some of these disorders affect the inner ear. The inner ear regulates balance. Symptoms of autoimmune inner ear disease are dizziness, ringing in the ears (tinnitus) and hearing loss.
There are some products (mouthwash, toothpaste, etc.) by the name of Biotene, which are designed to help with the problem of a dry mouth and gum problems resulting from medication use. Several listmembers have reported great relief by using these products. The pharmacies often don’t carry the products, but can order them.
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|2.2.1 Chronic Active and Chronic Persistent|