Author/Authors :
Osztovits, János First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Horváth, Evelin First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Tax, Judit First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Csihi, Levente First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Horváth, Tamás Institute of Human Physiology and Clinical Experimental Research - Semmelweis University - Budapest, Hungary , Littvay, Levente Central European University - Budapest, Hungary , Tóth, Tamás First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Abonyi, Margit First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , L. Lakatos, Péter First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Kollai, Márk Institute of Human Physiology and Clinical Experimental Research - Semmelweis University - Budapest, Hungary , Fehér, János Second Department of Internal Medicine - Semmelweis University - Budapest, Hungary , Szalay, Ferenc First Department of Internal Medicine - Semmelweis University - Budapest, Hungary , E. Blum, Hubert Second Department of Medicine - University of Freiburg - Freiburg, Germany
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.
