Reversible autonomic dysfunction during antiviral treatment in patients with chronic hepatitis C virus infection

authors:

avatar Janos Osztovits 1 , * , avatar Evelin Horvath 2 , avatar Judit Tax 2 , avatar Levente Csihi 2 , avatar Tamas Horvath 2 , avatar Levente Littvay 2 , avatar Tamas Toth 2 , avatar Margit Abonyi 2 , avatar Peter L Lakatos 2 , avatar Mark Kollai 2 , avatar Janos Feher 2 , avatar Ferenc Szalay 2 , avatar Hubert E Blum 3

First Department of Internal Medicine, Semmelweis University, janos.osztovits@gmail.com, Hungary
First Department of Internal Medicine, Semmelweis University, Hungary
Second Department of Medicine, University of Freiburg, Germany

how to cite: Osztovits J, Horvath E, Tax J, Csihi L, Horvath T, et al. Reversible autonomic dysfunction during antiviral treatment in patients with chronic hepatitis C virus infection. Hepat Mon. 2011;11(2): 114-118. 

Abstract

Background: The first clinical sign of chronic hepatitis C virus (HCV) infection can be one of the various extrahepatic manifestations. During antiviral treatment, symptoms of HCV-associated neuropathies usually improve, but can also worsen and lead to discontinuation of anti-HCV therapy. Recently, we have reported autonomic dysfunction in patients with HCV infection.
Objectives: In the present prospective study, we analyzed the changes of autonomic function during anti-HCV treatment.
Patients and Methods: Cardiovagal autonomic function was assessed in 22 HCV RNA-positive, treatment-naive patients by determining heart rate variability (HRV) and baroreflex sensitivity (BRS), at the beginning of treatment and 12, 24 and 48 weeks of antiviral therapy. interferon alfa-2 and ribavirin were given according to the guidelines.
Results: Both HRV and BRS time and frequency domain indices decreased after 12 weeks of therapy compared to the pre-treatment values; then the mean±SD values increased significantly by week 24 and continued to improve by week 48 of therapy-253.0±156.1 ms before therapy vs 111.6±81.9 at week 12, and 183.4±169.6 at week 24 vs 211.6±149.1 ms at week 48 for low-frequency HRV index; p<0.05 for all comparisons). These changes were independent from the presence of cryoglobulins and from virologic response.
Conclusions: The first rise followed by reversible autonomic dysfunction during antiviral therapy may be caused by the immunomodulatory actions of interferon alfa-2.

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