Dig Dis Sci 1997 May;42(5):1094-1099
Pruritis in chronic Hepatitis C: Association with high serum bile acids, advanced pathology, and bile duct abnormalities.
Lebovics E, Seif F, Kim D, Elhosseiny A, Dworkin BM, Casellas A, Clark S, Rosenthal WS
Pruritus is a common symptom of chronic cholestatic liver diseases but is considered
rare in chronic hepatitis. We observed pruritus to be an unusually common complaint
in patients with advanced chronic Hepatitis C. We reviewed the records of 175
chronic Hepatitis C patients to identify patients with severe, diffuse, unexplained
pruritus; 12 consecutive prospective patients undergoing liver biopsy for chronic
Hepatitis C served as controls. Assessment included laboratory biochemical tests
and assessment of liver pathology by stage, grade, hepatic activity index, and
a bile duct score. Pruritus was present in nine (5.1%) patients. Serum AST, ALT,
alkaline phosphatase, GGTP, total bilirubin, and ferritin were similar in pruritics
and controls. Pruritics had higher serum bile acids (2028.4 +/- 223.1 mmol/liter
vs 423.1 +/- 194.3, P
0.001), higher transferrin saturation (57.5 +/- 6.8% vs 33.2 +/- 3.3,
P
0.01), and lower HCV RNA by bDNA (24.5 +/- 12.7 x 10(5) vs 172.7
+/- 54.1 x 10(5), P
0.05). Pathology revealed cirrhosis in 6/9 (66.6%)
pruritics vs 1/12 (8.3%) controls (P
0.01). Pruritics had
higher pathologic stage (3.7 +/- 0.2 vs 2.2 +/- 0.4, P
0.01), grade (4.4 +/- 0.2 vs 2.1 +/- 0.2, P
0.001), activity index
(14.3 +/- 1.9 vs 8.6 +/- 1.9, P
0.025), and bile duct
score (7.6 +/- 0.6 vs 4.7 +/- 0.4, P
0.01). Of eight pruritics
treated with IFN-alpha2b, two had complete ALT response and one relapsed. Pruritus
followed a relapsing course and only three patients partially responded despite
a variety of interventions. In conclusion, pruritus is a common complication of
advanced CHC. Its presence is associated with high serum bile acids, advanced
pathology and bile duct abnormalities. The clinical course of pruritus is relapsing
and response to therapy is inconsistent. These features suggest that pruritus
in CHC has a pathogenesis that may vary from that of chronic cholestatic diseases.
PMID: 9149069, UI: 97293016
Site Topics
HCV Symptoms
You'll find links to a comprehensive symptoms list, as well as various studies and discussions about Hepatitis C symptoms.
Lab Tests
What they are and what they mean. Helps you interpret & understand all the various hepatitis lab tests likely to be encountered.
Hepatitis C Genotypes
Learn about Hepatitis C Genotypes and their variants.
Viral Load
Provides detailed information on how to analyze and interpret viral load numbers as well as a link to a convenient Viral Load Chart.
What is...?
Learn more about various Hepatitis C related topics, including HCV, Ascites, Biopsies, and much more.
HCV Medicines
Numerous links to studies, info sheets, FAQs, and analysis of Ribavirin/Rebetron medicines.
Glossary
Commonly used medical terms and definitions.
Hepatitis C Doctors
A state-by-state and worldwide reference listing physicians who treat HCV, including an email link to submit your physician for inclusion.
Biopsy Info
A comprehensive resource of information relating to the liver biopsy.
Cirrhosis
Many discussions and analyses of cirrhosis, including causes, complications, pathology, symptoms, and much more.
Liver Cancer
Liver Cancer/Hepatocellular Carcinoma studies, info sheets, FAQs, and analysis.
Liver Disease Medicines
An exhaustive list of links to studies, info sheets, FAQs, and analysis of the various drugs used to treat liver disease.
Hep-Central Email List
Sign up to learn about advances and breakthroughs in Hepatitis C research, including information about medical and complementary treatments.
HCV Links
Convenient links to other sites external to Hepatitis-Central.
-
HCV Transmission
Information about the transmission of Hepatitis C.
HCV Natural Remedies
A number of herbal products useful in the management of liver disease.
HCV Books
Recommended reading for those interested in hepatitis information.
Hepatitis C Forum
A Bulletin Board for discussions on hepatitis, treatments, etc.
Hepatitis C Activism
An easy way to get involved in urging our government to do more for Hepatitis C awareness and treatment research.

