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Paper Information

Journal:   HEPATITIS MONTHLY   FEBRUARY 2011 , Volume 11 , Number 2 (31); Page(s) 114 To 118.
 
Paper: 

REVERSIBLE AUTONOMIC DYSFUNCTION DURING ANTIVIRAL TREATMENT IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION

 
 
Author(s):  OSZTOVITS J.*, HORVATH E., TAX J., CSIHI L., HORVATH T., TOTH T., ABONYI M., LAKATOS P.L., KOLLAI M., FEHER J., SZALAY F., BLUME H.
 
* FIRST DEPARTMENT OF INTERNAL MEDICINE, SEMMELWEIS UNIVERSITY, KORÁNYI SÁNDOR UTCA 2/A, H-1083 BUDAPEST, HUNGARY
 
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.

 
Keyword(s): AUTONOMIC DYSFUNCTION, ANTIVIRAL TREATMENT, HEPATITIS C VIRUS
 
References: 
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