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

János Osztovits*, Evelin Horváth, Judit Tax, Levente Csihi, Tamás Horváth, Levente Littvay, Tamás Tóth, Margit Abonyi, Péter László Lakatos, Márk Kollai, János Fehér, Ferenc Szalay, Hubert E. Blum

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract (may include machine translation)

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.

Original languageEnglish
Pages (from-to)114-118
Number of pages5
JournalHepatitis Monthly
Volume11
Issue number2
StatePublished - Feb 2011

Keywords

  • Antiviral treatment
  • Autonomic dysfunction
  • Hepatitis C virus

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