FIBROMYALGIA IN HEPATITIS-C VIRUS-INFECTION - ANOTHER INFECTIOUS-DISEASE RELATIONSHIP

Background: Fibromyalgia syndrome (FS) is a common disorder of diffuse pain in the muscles or joints accompanied by tenderness at specific t ender points and a constellation of related symptoms. The potential ro le of infections in the pathogenesis of FS has only recently been inve stigated. Objectives: To evaluate the prevalence of FS and to assess t enderness thresholds in patients infected with hepatitis C virus (HCV) . Methods: The study included 90 patients with HCV, 128 healthy, anti- HCV-negative controls, and 32 patients with non-HCV-related cirrhosis. Tenderness was measured by manual palpation (18 tender points) and wi th a dolorimeter. Fibromyalgia syndrome was diagnosed according to the 1990 American College of Rheumatology criteria. Results: The diagnosi s of FS was established in 14 patients (16%) with HCV, in 1 patient (3 %) with non-HCV-related cirrhosis, and in none of the healthy controls (P<.001). Thirteen of the HCV-positive patients with FS were women. T he patients with HCV had significantly (P<.01) more tender points (mea n [+/-SD] 3.6+/-5.3) than the healthy controls (O.1+/-0.5) and the pat ients with non-HCV-related cirrhosis (1.2+/-2.7). Specifically, the pa tients with cirrhosis were most tender on both tenderness measures owi ng to the high proportion of women in this group. Patients with FS wer e significantly more tender than those without FS: their dolorimetry t hresholds were 2.9 kg vs 6.0 kg (P<.001). Conclusions: A high prevalen ce of FS was observed in patients infected with HCV, especially women. Recognizing FS in patients with HCV will prevent misinterpretation of FS symptoms as part of the liver disease and will enable the physicia n to reassure the patient about these symptoms and to alleviate them.