Hepatitis C Related Arthritis
A sero-negative (negative labs) arthritis is present in up to 20% of individuals with long standing HCV infection. Other common manifestations are carpal tunnel syndrome in 6%, Raynaud’s phenomenon in 3.5%, and symptoms of Sjogren’s syndrome in 8.7%.
Hepatitis C infection is common, affecting nearly 2 percent of the general population and a much higher percentage of people under special circumstances. Since the early 1990s, national statistics indicate that morbidity, mortality, and health care utilization associated with consequences of long-standing infection with hepatitis C are increasing in epidemic proportions.
The symptoms of hepatitis C related arthritis are similar to those in other inflammatory-based arthritis conditions, ie. rheumatoid arthritis. Pain, swelling and stiffness may begin in the small joints of the hands and progress to affect other small joints in the feet or other larger joints such as the shoulders, knees and hips.
A thorough medical history and physical examination is necessarily for a diagnosis of hepatitis C related arthritis in addition to laboratory and X-ray testing. Typically a screening test is done to look for antibodies directed against the hepatitis C virus. If the antibodies are identified, then the sub-type and amount of virus present in the body will be evaluated for. At times extensive workup is necessary to rule out other similarly presenting conditions.
The goal of treatment is to irradicate the hepatitis C virus and resolve the complications it has driven, ie. arthritis or other. Consultation with a hepatologist (liver specialist) is recommended to discuss the risks and benefits of treatment. Fortunately, the current treatment regimens designed for hepatitis C are more than 95% successful.
* Adopted from MD Consult Patient Handouts and The National Institute of Arthritis and Musculoskeletal and Skin Diseases site.