The hepatitis C virus (HCV) often does not always cause symptoms, but if the infection becomes chronic, it can cause complications over time. One of these is joint inflammation and pain.
Sometimes, joint pain is the first symptom that people with HCV notice, and in some cases, it may indicate arthritis. HCV is also associated with other conditions that can cause joint pain, such as fibromyalgia.
This article discusses the link between hepatitis C and joint pain, including the causes, related conditions, and treatment.
The reason why HCV can lead to joint pain is due to the immune system. As the body tries to destroy and clear the virus, the immune system activates, which can cause joint inflammation. With acute HCV, this symptom is usually temporary and resolves when the immune system clears the virus.
Overactivation of the immune system can also result in the body attacking its own healthy tissues by mistake, as well as other conditions, such as cryoglobulinemia. Cryoglobulinemia occurs when proteins in the blood become solid when cold, which may cause problems with blood vessels, or Raynaud’s disease.
Chronic HCV requires medical treatment, but detecting it can be difficult because it does not always cause obvious symptoms. Some people experience joint or muscle pain before they know they have HCV. In fact, muscle or joint pain along with unexplained fatigue tend to be the most common initial symptoms of chronic hepatitis C.
The following sections look at some of the rheumatic conditions HCV is associated with.
Unlike arthritis, arthralgia is joint pain without any obvious signs of joint swelling or inflammation. The symptoms include:
- joint pain
- joint stiffness
- reduced range of motion
Viruses such as HCV are a
Learn more about the differences between arthritis and arthralgia.
Rheumatoid arthritis (RA) occurs when the immune system mistakenly attacks the tissue that lines the joints. The symptoms include:
- painful and tender joints, often starting in the small joints of the hands or feet
- joint stiffness in the morning that lasts for 30 minutes or more
- symmetrical joint pain that affects both sides of the body, e.g., both hands
- unexplained fatigue
- low-grade fever
According to the Arthritis Foundation, researchers believe that viruses and other pathogens may cause the development of RA in people with certain genes. The treatment typically includes a combination of medications to reduce pain and inflammation, and lifestyle changes to help a person manage the symptoms.
It is also possible for people with HCV to test positive for
Fibromyalgia is a condition that causes widespread pain around the body, as well as other symptoms. Doctors are not sure how it develops, but viral illnesses are one of the risk factors. Early research suggests there may be a link specifically with HCV.
In a 2019 study, 7.6% of females with HCV also had fibromyalgia. The authors of the study concluded there was a positive association between the two conditions. People with RA are also more likely to get fibromyalgia.
The symptoms of fibromyalgia can include:
- widespread pain
- unexplained fatigue
- sleep problems
- problems with memory, thinking, or concentration
- increased sensitivity to pain
- headaches and migraine
- tingling or numbness in the feet or hands
- digestive symptoms
- pain in the jaw or face
- anxiety and depression
There is no known cure for fibromyalgia, so treatment focuses on reducing pain, improving quality of life, and addressing any underlying factors that could be contributing to the condition.
In addition to viruses, the risk factors for fibromyalgia include experiencing traumatic events or post-traumatic stress disorder, repeated physical injuries, and obesity.
According to the American College of Rheumatology, 97% of people that take direct-acting antivirals (DAAs) for HCV fully recover from the virus. In many cases, treating the infection improves or completely cures any joint pain.
For this reason, it is important to seek testing and treatment as soon as possible to prevent any long-lasting damage to the joints. In the meantime, joint and liver specialists should work together to help manage a person’s joint pain in a safe and effective way, as certain arthritis drugs may not be suitable for those with HCV.
For example, several RA drugs can damage the liver. If a person already has some liver damage due to advanced HCV, these drugs will not be suitable for them. Anti-tumor necrosis factor drugs appear to be safe for use in people with HCV, and researchers are testing more.
Anyone who suspects they may have HCV should speak with a doctor as soon as they can. This may be because they have new or unexplained symptoms, because they have several risk factors for contracting HCV, or both.
Tell a doctor about any:
- joint pain or stiffness
- muscle pain
- tiredness that is causing difficulty with daily activities
- low-grade fever
These symptoms do not necessarily mean a person has HCV, but a doctor can investigate the cause and find out.
It is also important to tell a doctor about any risk factors that make contracting HCV more likely. These include:
- any previous or current use of injectable drugs or unsterilized needles
- any previous or current use of shared instruments to sniff drugs, such a cocaine
- any exposure to blood that contains HCV, e.g., in a healthcare setting
- having received a blood infusion or organ transplant prior to
July 1992in the U.S.
- having HIV
- being born to a person with HCV
Hepatitis C can cause joint pain, and may trigger the onset of conditions such as RA. However, treatment with DAAs is highly effective and can cure joint problems associated with HCV. Seeking testing as early as possible is crucial for preventing more serious or irreversible complications from developing.
Speak with a doctor about any unexplained joint pain or stiffness, especially if it occurs with other symptoms, such as fatigue or a low-grade fever.