This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Severe fatigue is a common feature of hepatitis C virus (HCV) infection, affecting more than half of infected individuals and significantly contributing to the physical disability and poor quality of life experienced by these patients. Adrenal dysfunction has been explored as a possible factor in other diseases in which fatigue is a prominent manifestation, such as primary biliary cirrhosis and chronic fatigue syndrome. HCV has been associated with other disorders of the endocrine system, and it is possible that subtle defects of the adrenal axis may be responsible for the fatigue seen in patients with chronic HCV. The objective of this study is to determine whether adrenal insufficiency is present in patients with HCV and fatigue. The investigators hypothesize that patients with HCV and fatigue will have decreased adrenal gland responsiveness to stimulation with adrenocorticotropic hormone (ACTH) when compared to infected patients without fatigue and to patients without HCV or fatigue. Eligible subjects will be consented and studied at the GCRC at Bellevue Hospital. The investigators will assess adrenal function in the following three groups of patients: 1) patients with HCV and fatigue, 2) patients with HCV without fatigue, and 3) patients without HCV or fatigue. Fatigue will be assessed in patients through administration of the Fatigue Impact Scale (FIS), a self-administered questionnaire that has been previously validated for use in HCV. Adrenal function will be assessed by measuring the rise in serum cortisol after administration of ACTH.
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