[Pruritis and the Hepatitis C virus. The MULTIVIRC Unit].
[Article in French]
Dega H, Frances C, Dupin N, Lebre C, Simantov A, Callot C, Laporte JL, Blot C, Opolon P, Poynard T, Chosidow O
Service de Medecine Interne, Groupe hospitalier Pitie-Salpetriere, Paris.
Determine the characteristics of pruritis in a selected population of patients with positive Hepatitis C virus serology.
PATIENTS AND METHODS:
In a retrospective study, we re-examined outpatient reports for patients who consulted for pruritis from January 1993 to April 1996 and were followed in a hepatology unit for Hepatitis C infection. The following data were collected: age, sex, risk factors, HIV and HBV serologies, duration of pruritis and diagnosis, ALAT, gamma GT and total bilirubin, METAVIR score, HCV RNA PCR, search for cryoglobulins, antiviral and dermatology treatments. There were 1,060 patients followed in the hepatology unit during this period, including 327 with cirrhosis.
Twenty-seven patients were retained for study, 16 men and 11 women, mean age 53 years. None of the patients had HIV infection, 7 had a past history of Hepatitis B infection (positive for anti-Hbc antibodies). Median duration of pruritis prior to consultation was 3 months (95 p. 100 CI: 3 months-2 years). Pruritis was associated with non-specific lesion in 19 cases (70 p. 100: 95 p. 100 CI: 51-85 p. 100). There were excoriated eczema-like lesions in 11 cases (41 p. 100: 95 p. 100 CI: 15-49 p. 100). Other causes were urticaria in 5 cases (18 p. 100: 95 p. 100 CI: 7-36 p. 100), including 1 case of urticarial vasculitis with cryoglobulinemia, 2 cases with atopic dermatitis, and 1 case of primary biliary cirrhosis. In four cases, lichen planus was associated. Skin biopsies were obtained in 10 patients and showed eczema-like alterations in 9 and urticarial vasculitis in 1. Mean ALAT and gamma GT levels were 2.6 N (95 p. 100 CI: 1.9 N-3.3 N) and 2.2 N (95 p. 100 CI: 1.4 N-3 N) respectively, including 11 cases without cholestasis (normal gamma Gt). PCR was positive in 13 cases out of 15. Cryoglobulinemia was found in 10 cases out of 24. At consultation, 3 patients were given ursolvan, 7 interferon, 1 ursolvan with ribavirin, and 3 an interferon-ribavirin combination. Dermatology treatment associated antihistamine agents, emollients, and corticosteroids. This population of hepatology patients referred for pruritis comprised 2.5 p. 100 of all patients (95 p. 100 CI: 1.7-3.6 p. 100). Among them, 1.8 p. 100 (95 p. 100 CI: 1.1-2.7 p. 100) had eczema-like lesions associated with cutaneous xerosis.
Pruritis in our patient population was generally associated with non-specific excoriations, prurigo or xerosis in 19 cases (70 p. 100). As only ambulatory patients were retained for analysis, this is not a comprehensive population and the percentage of non-specific pruritis, evaluated at 1.8 p. 100, is probably an underestimation. Cholestasis cannot explain alone these manifestations since 11 patients had normal gamma GT levels. Several etiologies could be involved: a direct effect of HCV, interferon. A prospective study should allow an estimation of frequency, risk factors and possible impact on quality of life.
PMID: 9747198, UI: 98419335
Some of our most commonly asked questions and our answers to them.
Learn about the Hepatitis C Virus (HCV).
Information about the transmission of Hepatitis C.
You'll find links to a comprehensive symptoms list, as well as various studies and discussions about Hepatitis C symptoms.
Learn about the conventional medical treatments used to fight Hepatitis C.
Numerous links to studies, info sheets, FAQs, and analysis of Ribavirin/Rebetron medicines.
Alternative methods of treatment due to side effects and dissatisfication with current medical treatments.
A number of herbal products useful in the management of liver disease.
Receive the latest news on hepatitis treatments, clinical trials, social issues and important breakthroughs.
Learn about Hepatitis C Genotypes and their variants.
A state-by-state and worldwide reference listing physicians who treat HCV, including an email link to submit your physician for inclusion.
Convenient links to other sites external to Hepatitis-Central.
A Bulletin Board for discussions on hepatitis, treatments, etc.
An easy way to get involved in urging our government to do more for Hepatitis C awareness and treatment research.
Numerous links to various Hepatitis B related information, including transmission, symptoms and treatment.
A comprehensive resource of information relating to the liver biopsy.
Many discussions and analyses of cirrhosis, including causes, complications, pathology, symptoms, and much more.
Commonly used medical terms and definitions.
What they are and what they mean. Helps you interpret & understand all the various hepatitis lab tests likely to be encountered.
Liver Cancer/Hepatocellular Carcinoma studies, info sheets, FAQs, and analysis.
An exhaustive list of links to studies, info sheets, FAQs, and analysis of the various drugs used to treat liver disease.
Provides information regarding the best known liver supporting supplements.
Provides information regarding the best known milk thistle supplements.
Provides detailed information on how to analyze and interpret viral load numbers as well as a link to a convenient Viral Load Chart.
Learn more about various Hepatitis C related topics, including HCV, Ascites, Biopsies, and much more.
Recommended reading for those interested in hepatitis information.