Reversible autonomic dysfunction during antiviral treatment in patients with chronic hepatitis C virus infection: Anti-HCV therapy and autonomic function.

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.

• Authors: Janos Osztovits, Evelin Horvath, Judit Tax, Levente Csihi, Tamas Horvath, Levente Littvay, Tamas Toth, Margit Abonyi, Peter L Lakatos, Mark Kollai, Janos Feher, Ferenc Szalay, Hubert E Blum
• Journal: Hepatitis monthly (Hepat Mon) Vol. 11 Issue 2 Pg. 114-8 (Feb 2011) ISSN: 1735-3408 [Electronic] Netherlands
• PMID: 22087127 (Publication Type: Journal Article)