Managing the Symptoms of Hepatitis C
Some people with hepatitis C (HCV) infection experience few or no symptoms. This is true even in cases where HCV results in considerable damage to the liver, because the liver is able to sustain considerable damage without complaining. This apparent lack of symptoms in some people is why HCV is sometimes called a “silent” disease.
However, some common symptoms may affect you if you have HCV. Fatigue is the most common of these symptoms. Others include:1
- Abdominal discomfort or pain
- Flu-like symptoms (headache, fever, body aches)
- Muscle aches and joint pain
- Nausea and diarrhea
HCV doesn’t just affect the liver; it may affect other organ systems in your body. If your skin is affected, HCV can cause various types of rashes and pruritis (severe itching). You may also experience a condition called Sicca syndrome, which is characterized by dry eyes and dry mouth.2
If you have HCV and experience symptoms, it is important to know how to manage your symptoms so that you can continue to enjoy your life. Speak with your doctor about your HCV symptoms and ask for tips on how to manage these.
Fatigue is the most common HCV symptom. When you are fatigued, you feel exhausted and tired. Accomplishing even the simplest of daily tasks becomes a chore. Fatigue has many causes besides HCV. In order to manage fatigue, you need to know what’s causing or contributing to it. So, the first thing your doctor will do is to check to see if your fatigue is related to another condition, such as sleep problems, thyroid disease, diabetes, depression, or a blood abnormality, such as anemia. If your fatigue is related to another medical condition, your doctor will address that condition. For instance, if you’re fatigued because of poor sleep, your doctor may offer you sleep tips or medication to help you sleep.3
Tips for managing fatigue
|Get the sleep you need||
|Eat a healthy diet||
|Get regular exercise||
|Stay hydrated and limit caffeine and smoking||
|Reduce the stress in your life||
|Budget your time and energy||
People with HCV may experience flu-like symptoms, including muscle and joint pain, headache, and fever. These symptoms can vary in duration and severity. Flu-like symptoms are common during HCV treatment, especially when peginterferon is used.
Your doctor may suggest prescription or over-the-counter medications to relieve fever, headache, and joint or muscle pain. Tylenol (acetaminophen) is a common fever-reducing medication. Tylenol and other over-the-counter pain relievers (ibuprofen, Naprosyn) are effective at relieving headaches and joint or muscle pain. Make sure you talk to your doctor before you take any medication (prescription or nonprescription) to avoid interactions with other drugs that you may be taking. If you are told to take Tylenol, make sure to take it according to the directions on the label and never take Tylenol if you are drinking alcohol.4,5
There are a number of treatment options to alleviate muscle and joint pain. However, first it’s important to identify the cause of these symptoms. Talk to your doctor about possible injuries or other causes of pain. Your doctor may suggest medication or home remedies to help manage the pain. Home remedies to relieve muscle and joint pain include gentle stretching and soaking in a warm bath. Massage and alternative medical approaches such as acupressure may also be useful.5
Your doctor may also offer you medication to help relieve headaches. Headache home remedies including stress reduction techniques, such as meditation or other relaxation techniques, may be useful. Massage and alternative medical approaches such as acupressure may also be useful.
Abdominal pain, nausea, and vomiting
Abdominal pain (pain in the liver) may occur with HCV. Additionally, you may be affected by gastrointestinal symptoms, including nausea and diarrhea. Talk to your doctor if you have any of these symptoms. The first step in management will be to identify the cause. Steps you can take on your own to relieve nausea include eating small amounts of food several times per day, instead of eating two or three large meals. Also, avoid acidic foods that are harsh on your digestive tract, such as citrus and tomatoes.
Talk to your doctor about getting a referral to a registered dietician to help you develop a healthy eating plan. A dietician with experience helping people with chronic conditions like HCV infection will address specific gastrointestinal symptoms and show you how healthy eating can improve your general health.
Dryness of skin, eyes, and mouth
If you have HCV, you may experience dryness that affects the eyes, mouth, and skin. Dry mouth and eyes may be related to a condition called Sicca syndrome, which occurs in some people with HCV. HCV is also associated with a range of dermatologic conditions that can cause changes in the skin, including dryness and scaling. To help manage dryness, make sure you are drinking an adequate amount of water during the day. The average adult should get about 8 glasses of water per day. Avoid using harsh skin cleansing products and use unscented lotion (designed for sensitive skin) after bathing to help maintain skin moisture. Avoid direct sun, and wear protective clothing to block the sun. Make sure to use a sunscreen (SPF 30 or higher) if you are going outdoors.6
Over-the-counter teardrop products may be useful in managing dry eyes. Talk to your dentist or doctor about options for relieving dry mouth. You can also talk to your pharmacist about toothpastes and mouthwashes formulated for dry mouth. Sucking on sugar-free lozenges may also help. Additionally, saline sprays may help with dry nasal passages.
Having a chronic illness such as HCV can be emotionally challenging. Living with HCV is associated with depression, anxiety, stress, and other emotional problems.3
Stress affects most people, whether it has to do with work or difficult life situations. However, a person with HCV tends to live with more stress than other people without a chronic health condition. There are many ways to relieve stress, including regular exercise, yoga, meditation, and other relaxation techniques. Counseling may also help you cope with stress, especially if you work with a professional who specializes in stress management.
Anxiety typically happens in response to life circumstances, such as living with the uncertainty and stress of having a disease such as HCV. Different stressors, like uncertainty about the future can trigger or worsen anxiety. Talk to your doctor about treatment for anxiety.
Counseling or stress reduction training may help reduce anxiety. These interventions can help you understand the source of anxiety and develop ways to handle anxious feelings. In addition to non-drug interventions, medication may be effective at treating anxiety. Talk to your doctor about whether an anti-anxiety medication might help you.
Depression is one of the most common psychiatric complications associated with HCV. Some studies found that up to a half of people with HCV experienced depression. Additionally, interferon-based treatment for HCV is associated with depression. Since depression is a serious condition that can increase the risk that you will harm yourself, it is important to be aware of its symptoms and to get help as quickly as possible.3
- Chopra S. Clinical manifestations and natural history of chronic hepatitis C virus infection. Uptodate. Di Bisceglie AM, Bloom A, eds. Accessed at: www.uptodate.com. 2014.
- Chopra S. Extrahepatic manifestations of hepatitis C virus infection. Uptodate. Di Bisceglie AM, Bloom A, eds. Accessed at: www.uptodate.com. 2014.
- Saunders JC. Neuropsychiatric symptoms of hepatitis C. Issues Ment Health Nurs 2008;29:209-20.
- Chopra S. Overview of the management of chronic hepatitis C virus infection. Di Bisceglie AM, Bloom A, eds. Accessed at: www.uptodate.com. 2014.
- Poll R. The role of the community nurse in hepatitis C diagnosis and treatment. Br J Community Nurs 2009;14:294-6.
- Kelleher TB, Afdhal NH. Management of the side effects of peginterferon and ribavirin used for treatment of chronic hepatitis C virus infection. Di Bisceglie AM, Bloom A, eds. Accessed at: www.uptodate.com. 2014.