Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
The Prevalence of Fibromyalgia in Patients with Chronic Hepatitis C Infection.
Mohammad1, Ausaf, Carey4, John J., Storan2, Eoin R., Scarry2, Margaret, Keane2, Mary B., Moore2, Angela, Lyons2, Ann
Chronic HCV infection is associated with rheumatologic conditions including arthritis and vasculitis. Previous studies have not specifically addressed the presence of fibromyalgia syndrome (FMS) in this population. In this study we assessed the prevalence of fibromyalgia in a cohort of subjects with chronic HCV and its relationship to subject demographics, viral characteristics and quality of life.
Cross-sectional study of a cohort of HCV infected individuals at our university hospital. Study was approved by local I.R.B. and all subjects gave written informed consent prior to participation. Patients with decompensated liver disease, concomitant autoimmune liver disease, arthritis, vasculitis, co-infection with hepatitis B or D, or HIV, end-stage renal failure, organ transplantation, cancer and those patients who were currently receiving anti-viral treatment were excluded. All subjects underwent a single interview including a fibromyalgia impact questionnaire, pain assessment measured on a 100-mm visual analogue scale (VAS) and the Stanford Health Assessment Questionnaire 20-Item Disability Scale (HAQ-DI). All patients underwent clinical examination including a standard assessment for fibromyalgia tender points. Additional details were recorded from the medical record including information about their HCV infection and its treatment, laboratory data including antibody profiles, other illnesses and medications.
185 patients attending the hepatology unit consented to participate. 110 (59%) were females with a mean age of 46.7 years. 106 (57%) subjects met criteria for the presence of FMS. Widespread pain and >=11 tender points were present in all of the subjects with fibromyalgia, fatigue in 98 (92%), depression in 60 (57%), and arthralgia/ joint stiffness in 16 (15%). Among those with FMS mean pain score was 70 ± 11.78 and 36% reported some functional impairment on HAQ-DI (>0), with 17% reporting moderate-severe functional impairment (HAQ-DI >=1.5). Compared to subjects who did not meet criteria for fibromyalgia, patients with fibromyalgia were more likely to be older, females, living alone, smokers, have a history of depression, had acquired HCV via a blood transfusion, and had HCV genotype-1(table 1, p <0.005 for all categories).
Table 1. Comparing HCV infected subjects with and without FMS
|Chronic HCV patients with FMS (n = 106)||Chronic HCV patients without FMS (n = 79)||t, p value|
|Female||82 (77%)||28 (35%)||17.6; 0.001|
|age >= 45 years||80 (73%)||26 (33%)||17.9; 0.001|
|Wide spread pain||106 (100%)||20 (25%)||25.7; 0.001|
|Depression||60 (57%)||20 (25%)||15.3; 0.001|
|HCV acquisition via blood transfusion||65 (61%)||26 (33%)||15.0; 0.001|
|Genotype 1||82 (77%)||20 (25%)||20.4; 0.001|
The prevalence of FMS was very high (57%) among subjects with HCV infection, one third of whom reported some degree of functional impairment. Further research is needed to better understand FMS in patients with HCV.
To cite this abstract, please use the following information:
Mohammad, Ausaf, Carey, John J., Storan, Eoin R., Scarry, Margaret, Keane, Mary B., Moore, Angela, et al; The Prevalence of Fibromyalgia in Patients with Chronic Hepatitis C Infection. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :817