Reversible autonomic dysfunction during antiviral treatment in patients with chronic hepatitis C virus infection
Janos Osztovits
1
, *
,
Evelin Horvath
2
,
Judit Tax
2
,
Levente Csihi
2
,
Tamas Horvath
2
,
Levente Littvay
2
,
Tamas Toth
2
,
Margit Abonyi
2
,
Peter L Lakatos
2
,
Mark Kollai
2
,
Janos Feher
2
,
Ferenc Szalay
2
and
Hubert E Blum
3
1 First Department of Internal Medicine, Semmelweis University, janos.osztovits@gmail.com, Hungary
2 First Department of Internal Medicine, Semmelweis University, Hungary
3 Second Department of Medicine, University of Freiburg, Germany
*
First Department of Internal Medicine, Semmelweis University, janos.osztovits@gmail.com, Hungary. Tel: +36-305233368. Fax: +36-12101007. Email:
janos.osztovits@gmail.com
Hepatitis Monthly: 11 (2) ; 114-118 Article Type: Research Article
Received:
September 8, 2010
Accepted:
November 15, 2010
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.
Online ahead of Print
; 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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