Does Chronic Hepatitis C Cause Fatigue?

Author: Kielland KB, Landheim AS

Theme: Epidemiology & Public Health Research Year: 2016


Kielland KB1, Landheim AS1

1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Norway

Background: An association between chronic hepatitis C (CHC) and chronic fatigue is found in numerous studies. But is this association a causal one? Does CHC cause chronic fatigue? Or is the association due to confounders – for example patient awareness of having a chronic infection? The aim of this study is to illuminate that question. The study is ongoing and planned to be terminated during the late fall of 2016.

Methods: In a study conducted in 1997 and 1998 on concurrent substance abuse and mental disorder, a cohort of 281 patients who had been admitted for substance abuse treatment in two counties of Norway underwent a diagnostic assessment on mental disorder and substance abuse. One hundred and fourteen patients reported lifetime injecting drug use (IDU). Their age at the first injection was known. The assessment included questions directly relevant for chronic fatigue. Information on hepatitis C virus (HCV) will be obtained through linkage to laboratories of microbiology. The level of fatigue among anti-HCV positive people who inject drugs (PWID) with spontaneous clearance (HCV RNA negative) will be compared to PWID with CHC (HCV RNA positive).

Results: One result is clear: Among people with substance abuse, those who report lifetime IDU have a significantly higher fatigue score than those using drugs or alcohol without injections. We expect to be able to present some results on the main research question at the INHSU symposium 7-9 September 2016.

Conclusion: If the level of fatigue in 1998 is found to be higher among PWID with CHC compared to PWID with spontaneous clearance, the difference may be caused directly by the HCV-infection. PWID in 1998 usually were not aware of HCV, so a difference in fatigue score at that time probably would not be caused by patients’ awareness of having a chronic infectious disease.

Disclosures: KB Kielland has given sponsored lectures for MSD and Abbvie. AS Landheim declares no conflict of interest

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