HCV & Rheumatic Disease
(Part 2)
This is the second part of our discussion of HCV & Rheumatic Disease
Living with HCV & Rheumatic Disease
Reducing risk factors may help prevent the spread of HCV to others. Those at risk should get tested for HCV. Because HCV-related joint and muscle problems may cause discomfort and make daily activities difficult, see a rheumatology provider for treatment. Long-term follow-up care with a specialist for HCV infection is important, as liver disease may worsen over time and lead to liver failure or liver cancer.
Reactive arthritis
Reactive arthritis is an inflammatory disease that occurs in reaction to infections by certain bacteria particularly involving the genitourinary or gastrointestinal system.
The most common infections include the sexually transmitted infection Chlamydia trachomatis, and bowel infections like Clostridium difficile, Campylobacter, Salmonella, Shigella and Yersinia.
Arthritis may present several weeks after the infection. Once called Reiter’s syndrome, reactive arthritis is a “spondyloarthropathy.”
Reactive arthritis often affects men between 20 and 50 and symptoms can last for days or become a chronic condition.
What Are the Signs/Symptoms?
Reactive arthritis symptoms include pain and swelling in knees, ankles, or heels; swelling of toes or fingers; and persistent lower back pain that tends to be more severe at night or in the morning. It may cause irritating, red eyes, burning during urination, or a rash on the palms or soles of the feet. To diagnose reactive arthritis, a rheumatologist may look for these symptoms as well as signs of the original infection. It is important to remember that most people with these very common infections don’t get reactive arthritis. People who test positive for the HLA-B27 gene may be at higher risk for severe or chronic arthritis, but those who test negative may get reactive arthritis too. People with weakened immune systems from HIV or AIDS may also develop reactive arthritis.
What Are Common Treatments?
Effective treatments are available for reactive arthritis. It is treated according to how far the disease has progressed. In the early, acute stage, nonsteroidal anti-inflammatory drugs (NSAIDs) treat inflammation. These include ibuprofen, naproxen, diclofenac, indomethacin, celecoxib, amongst others. Dose and side effects of NSAIDs may vary from person to person. Later-stage, or chronic reactive arthritis, may be treated with disease-modifying antirheumatic drugs (DMARDs) like sulfasalazine, or methotrexate. Patients with severe joint inflammation may need corticosteroid injections, or even biologics like etanercept or adalimumab.
Living with Reactive Arthritis
Early diagnosis and treatment of reactive arthritis is key. Patients who notice arthritis symptoms about a month after a bacterial infection should see a healthcare professional right away to get a diagnosis. Sometimes, reactive arthritis symptoms go away or are effectively treated with NSAIDs. Chronic or severe disease occurs in some people, but there are treatments available. These medications may have side effects, so patients should talk with their rheumatologists about the risks and benets of these treatments.