Peripheral Neuropathy And Hepatitis

Today's post from hcvadvocate.org (see link below) is a very useful one for people living with hepatitis C, who also suffer neuropathic problems as a result. You won't find too much information on the net about the two diseases together but this article tries to show why neuropathy can be hepatitis (HCV) -related and once again, it's the treatment of the one disease, that may lead to the other occurring. Unfortunately hepatitis C is a serious problem and the numbers are growing. There are new treatments just coming onto the market but it remains a very difficult viral disease to treat and then with neuropathy on top...well you know the rest. The only light point (if you can call it that) is that the treatment for HCV-related neuropathy is much the same as for most other forms of neuropathy - there are no real deviations just because of the cause and neuropathy patients will recognise the recommendations and suggestions shown here.

HCV – Peripheral 

Neuropathy (PN)

Written by: Alan Franciscus, Editor-in-Chief Hepatitis C Support Project

Foreword

Neuropathy is a medical term for any disease of the nerves. There are

four major forms of neuropathy – polyneuropathy, autonomic neuropathy,

mononeuropathy and the most common form, peripheral polyneuropathy

– more commonly called peripheral neuropathy (PN). Peripheral neuropa

-

thy damages the nerves in the legs and arms. Usually the first area that

PN affects is the feet and legs before the hands and arms. This fact sheet

will discuss the HCV-related form of peripheral neuropathy including the

cause, symptoms, and treatments.

 HCV & PN

The exact cause of HCV-related PN is not completely understood, but

there is some speculation that it could be caused by HCV RNA (viral

load) deposits in blood vessels that supply oxygen to the nerves,

HCV infection of the nerves, an inflammation process in the nerves,

and/or an HCV-related immune disorder. In the past it was believed

that only people with cryoglobulinemia developed HCV-related PN

but it has been proven that HCV-related PN can occur even in the

absence of cryoglobulinemia. Studies have found that up to 15.3% of

the HCV population has PN. If HCV is the cause of PN it would make

sense to treat the cause.

Important note:

Everyone with hepatitis C should be evaluated and receive HCV treatment. Current treatment is very expensive, and some insurance companies and Medicaid/Medicare are restricting HCV treatment to people with the most severe HCV disease. One of the conditions that qualify people for HCV treatment are extrahepatic manifestations. Discuss any symptoms with your medical provider and have them recorded in your medical records. If you are not approved

for the drugs to treat hepatitis C, you may qualify for free drugs or co-pay assistance through a pharmaceutical patient assistance program. More information is available at the end of this fact sheet.

Causes and Risk factors for PN include:

•

Infections such as hepatitis C, Lyme disease, shingles, Epstein-Barr, and HIV

•

The most common cause of PN is diabetes – it is estimated that 34% of the diabetic population has PN. This compares to a prevalence of 2.4 - 8% in the general population

•

Chronic alcohol abuse

•

Vitamin B deficiencies

•

Various autoimmune diseases such as lupus

and rheumatoid arthritis

•

Environmental toxins

•

Medications, such as HIV medications

Symptoms

The most common symptoms of PN are HCV therapy.

 

Self-Care Tips:

A healthy lifestyle can help manage PN and the symptoms associated with it. These lifestyle modifications include:

•

Exercise

– can help to reduce some of the symptoms, increase overall muscle strength,

increase blood circulation, and prevent muscle wasting or atrophy.

•

Nutrition

– Eat a healthy diet that will improve overall health and which may help with the gastrointestinal symptoms people with PN experience.

•

Smoking

– Cigarette smoking constricts the blood vessels that provide oxygen and nutrients to peripheral nerves. Seek professional services to stop smoking.

•

Drinking

– Alcohol abuse is a leading cause of PN. Avoid or greatly reduce alcohol use.

•

Massage

– especially to areas that are affected by PN (hands/feet) will stimulate, relax and may lessen some of the pain

•

Do not put too much pressure on limbs-legs and elbows such as crossing legs for a long period of time.

Foot Care

As discussed earlier PN usually affects the feet and legs first. Because NP can cause loss of sensation to the lower extremities it is very important that people with PN pay special attention to their feet. The loss of sensation caused by PN can lead to unrecognized cuts, blisters and other damage to the feet. If a condition or injury goes unchecked it could lead to infections and ulcerations that may spread to the bone. Severe bone infection can lead to amputation of the infected bone. There are many ways to take care of and protect your

feet. The American Diabetes Association (ADA) recommendations for foot care can be easily adapted to everyone with PN:

•

Check all the areas of the feet every single day. Look for red spots, cuts, swelling and blisters. If you can not see the bottom of your feet, use a mirror or ask someone to inspect them for you.

•

Be more active (exercise and stretching).

•

Wash your feet everyday. Dry them carefully, especially between the toes.

•

Moisturize your feet daily (but not between the toes).

•

Never go barefoot – always wear comfortable shoes and socks. This is because people with PN can cut or damage their feet and may not even notice or feel the pain.

•

Keep toe nails trimmed so that the nails don’t rub or cut nearby toes.

•

Be careful not to expose your feet to hot and cold temperatures.

•

Keep the blood circulating throughout the feet. The ADA recommends wiggling your ankles up and down for 5 minutes – two or three times a day. Don’t cross your legs for long periods of time.

•

Stop smoking cigarettes.

•

Check with your medical provider about the need for special shoes (orthotics).

http://hcvadvocate.org/hepatitis/factsheets_pdf/pn.pdf