Hepatitis C Virus Might Induce
A Portland Oregon study suggests hepatitis C may trigger fibromyalgia.
The study is the first to show a link between the two illnesses.
Fibromyalgia often arises after a traumatic event or an illness. Several
infections have previously been proposed as potential inciters of
fibromyalgia, including Lyme disease and the human herpes virus-6.
Published in the Journal of Clinical Rheumatology’s August 1996 issue,
the 12-patient study determined that the relationship between hepatitis
C virus and fibromyalgia followed three distinct patterns:
In nine patients, fibromyalgia developed as a long-term complication of
the hepatitis, arising on average 13.4 years after the virus was
In two patients, fibromyalgia arose simultaneously with the hepatitis C
In one patient, pre-existing fibromyalgia was significantly worsened by
the hepatitis C.
Six of the 12 patients were dosed with fibromyalgia after initial
evaluations for musculoskeletal complaints. All had the chance of
contracting hepatitis C through either blood or body fluid exposure.
Three used intravenous blood products, one experienced an occupational
needle stick, three had tattoos, three used intravenous drugs, and two
engaged in promiscuous sexual practices.
The reason for the link between hepatitis C and fibromyalgia is unknown.
The authors propose, however, that hepatitis C causes chronic activation
of the immune system that leads to muscle aching, fatigue, mental
changes, sleep abnormalities, and alterations of the neuroendocrine
The patients with both hepatitis C and fibromyalgia could be
distinguished from most other patients with fibromyalgia alone because
they had symptoms unusual to fibromyalgia. These symptoms include
synovitis (inflammation of the membrane around a joint, bursa, or
tendon) and vasculitis (inflammation of a blood or lymph vessel). In
addition, laboratory findings pointed to a disease process other than
The study was conducted at Oregon Health Sciences University and
Portland Adventist Hospital.
Source: "Fibromyalgia: A prominent feature in patients with
musculoskeletal problems in chronic hepatitis C, A report of 12
patients,"by A. Barkhuizen, G.S. Schoepflin, and R.M. Bennett, Journal
of Clinical Rheumatology, Vol. 2.
Questions & Answers about Fibromyalgia
National Institute of Arthritis and Musculoskeletal and Skin Diseases
What is Fibromyalgia?
Fibromyalgia is a chronic disorder characterized by widespread
musculoskelatal pain, fatigue, and multiple tender points. “Tender
points” refers to tenderness that occurs in precise, localized areas,
particularly in the neck, spine, shoulders, and hips. People with this
syndrome may also experience sleep disturbances, morning stiffness,
irritable bowel syndrome, anxiety and other symptoms.
How many people have Fibromyalgia?
According to the American College of Rheumatology, fibromyalgia affects
3 to 6 million Americans. It primarily occurs in women of childbearing
age, but children, the elderly, and men can also be affected.
What Causes Fibromyalgia?
Although the cause of fibromyalgia is unknown, researchers have several
theories about causes or triggers of the disease. Some scientists
believe that the syndrome may be caused by an injury or trauma. This
injury may affect the central nervous system. Fibromyalgia may be
associated with changes in muscle metabolism, such as decreased blood
flow, causing fatigue and decreased strength. Others believe the
syndrome may be triggered by an infectious agent such as a virus in
susceptible people, but no such agent has been identified.
How is Fibromyalgia Diagnosed?
Fibromyalgia is difficult to diagnose because many of the symptoms mimic
those of other diseases. The physician reviews the patient’s medical
history and makes a diagnosis of fibromyalgia based on a history of
chronic widespread pain that persists more than 3 months. The American
College of Rheumatology (ACR) has developed criteria for fibromyalgia
that physicians can use in diagnosing the disease. According to ACR
criteria, a person is considered to have fibromyalgia if he or she has
wide-spread pain in combination with tenderness in at least 11 of 18
specific tender point sites.
How is Fibromyalgia Treated?
Treatment of fibromyalgia requires a comprehensive approach. The
physician, physical therapist, and patient may all play an active role
in the management of fibromyalgia. Studies have shown that aerobic
exercise, such as swimming and walking, improve muscle fitness and
reduces muscle pain and tenderness. Heat and message may also give
short-term relief. Antidepressant medications may help elevate mood,
improve quality of sleep, and relax muscles. Fibromyalgia patients may
benefit from a combination of exercise, medication, physical therapy,
What Research is Being Conducted on Fibromyalgia?
The NIAMS is sponsoring research that will increase understanding of the
specific abnormalities that cause and accompany fibromyalgia with the
hope of developing better ways to diagnose, treat and prevent this
Recent NIAMS studies show that abnormally low levels of the hormone
cortisol may be associated with fibromyalgia. At Brigham and Women’s
Hospital in Boston, and at the University of Michigan Medical Center in
Ann Arbor, researchers are studying regulation of the function of the
adrenal gland (which makes cortisol) in fibromyalgia. People whose
bodies make inadequate amounts of cortisol experience many of the same
symptoms as people with fibromyalgia. It is hoped that these studies
will increase understanding about fibromyalgia and may suggest new ways
to treat the disorder.
Other NIAMS research studies are looking at different aspects of the
disease. At the University of Alabama in Birmingham, researchers are
concentrating on how specific brain structures are involved in the
painful symptoms of fibromyalgia. Researchers at Vanderbilt University
in Nashville are using magnetic resonance imaging (MRI) and magnetic
resonance spectroscopy (MRS) techniques to study patients with
fibromyalgia. MRI and MRS are powerful tools that have been shown to be
useful in evaluating muscle disorders and muscle performance. At the New
York Medical College in Valhalla, scientists are investigating the cause
of a post-Lyme disease syndrome as a model for fibromyalgia. Some
patients develop a fibromyalgia-like condition following Lyme disease,
an infectious disorder associated with arthritis and other symptoms.