Prevalence of fibromyalgia, anxiety and depression in chronic hepatitis C virus infection: relationship to RT-PCR status and mode of acquisition

Background Musculoskeletal complaints, dry eyes, fatigue and anxiety are co mmon symptoms in patients with hepatitis C virus (HCV) infection, but there are few controlled data evaluating this. Aim To assess the prevalence of rheumatological disease, fatigue and anxiet y in different groups of patients with chronic HCV infection. Patients and methods Seventy-seven patients with HCV were evaluated. Of the se, 49 (64%) had been infected via contaminated anti-D immunoglobulin, 25 ( 33%) were intravenous drug users (IVDUs), and three were transfusion relate d; 78% were female. Twenty-five age- and sex-matched controls were also eva luated. Assessment was performed by history, physical examination, the Fibr omyalgia Impact Questionnaire (FIQ) and the Hospital Anxiety and Depression Score (HADS). Results Four (5%) patients fulfilled the criteria for fibromyalgia. All wer e infected via anti-D immunoglobulin, and three were PCR positive. The mean number of tender points in anti-D patients was 5.0 (+/- 4.07) compared wit h 2.8 (+/- 2.7) in controls (P = 0.028) and 2.5 (+/- 2.2) in IVDUs (P < 0.0 04). There was no significant difference in the number of tender points bet ween POP-positive and PCR-negative patients (P = 0.23). Anxiety and depress ion scores were significantly higher in anti-D patients (P = 0.0001) and IV DUs (P = 0.005) compared with controls. Forty per cent of the HCV patients had a positive Schirmer test. Forty-two per cent of POP-positive patients h ad a positive rheumatoid factor (RF, > 1/80). Conclusion This study reveals a moderate increase in prevalence of fibromya lgia in HCV patients. The number of tender points was related to mode of ac quisition but not to PCR status. Anxiety and depression levels are also inc reased in HCV patients compared with controls. Prevalence of RF was higher in PCR-positive patients compared with controls and those who had cleared t he virus. Eur J Gastroenterol Hepatol 13:507 - 511 (C) 2001 Lippincott Will iams & Wilkins.