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Viral Hepatitis

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Pain Associated with Hepatitis C

for Veterans and the Public

Pain associated with hepatitis C - Hepatitis C for Patients

Some patients with hepatitis C feel discomfort in the abdomen or in the area of the liver. This may be a dull ache or a sharp pain. Sometimes the pain can be mild, and occasionally it can be severe. The pain may come and go, or, for a few patients, it may persist. This sort of pain may be caused by a stretching of the outer edge of the liver, but it does not mean the hepatitis C is worsening. Patients who have new or worsening abdominal pain should always be seen in person by a provider. The provider may decide that an ultrasound or other test is needed to check for any changes in the liver that could be causing the pain.

Some people with hepatitis C experience sore joints--often in the small joints of the hands or ankles or wrists, but occasionally in other areas. Once in a while, hepatitis C causes the body to produce small proteins called "cryoglobulins," which can cause joint pain. If you develop joint pain, you should see your doctor and ask about cryoglobulins. Of course, most people who have hand pain or joint pain do not have hepatitis C, such as hand pain caused by arthritis, tendonitis orcarpal tunnel syndrome.

If there is abdominal pain due to hepatitis C, treating the hepatitis C with direct acting antiviral (DAA) medications and achieving a cure of the virus may or may not change the pain. Treatment of the hepatitis C virus will stop or slow the development of fibrosis in the liver, but this does not necessarily have any effect on abdominal pain.

However, if there is pain due to hepatitis C related cryoglobulinemia, then the cure of the hepatitis C virus will most likely eliminate the cryoglobulins and improve the associated joint pains. If you have hepatitis C and cryoglobulins are detected, then treatment of hepatitis C with DAAs is especially important. Cryoglobulinemia is a reason to consider treatment of hepatitis C as urgent.

To summarize: Many people with hepatitis C experience pain--sometimes pain in the liver, sometimes joint pains. Having abdominal pain does not necessarily mean that the hepatitis C is "getting worse," but if the pain is new or worsening, then being seen in person by a provider is important. If joint pain is being experienced, then a provider may order a test for cryoglobulinemia. If the test result is positive, then treatment of the hepatitis C virus should be strongly considered and may improve the joint condition. Most importantly, no matter where the pain is felt, it is important for you to discuss any sort of pain and any concerns with your health care provider.