Vagal system impairment in human immunodeficiency virus-positive patients with chronic hepatitis C: does hepatic glutathione deficiency have a pathogenetic role?
BACKGROUND
Both an autonomic impairment and a systemic depletion of reduced glutathione (GSH) may be documented in patients with chronic liver diseases and in human immunodeficiency virus (HIV)-positive patients.


METHODS
The coefficients of electrocardiographic R-R interval variation (CVc) were assessed in 125 patients with chronic hepatitis C (CHC) (65 HIV-positive and 60 HIV-negative) and in 61 healthy controls. The CVc values were correlated with hepatic (H-GSH), plasmatic (P-GSH), lymphocyte (L-GSH), and erythrocyte (E-GSH) concentrations of GSH and with erythrocyte malonyldialdehyde (MDA) levels.


RESULTS
Compared with healthy controls, in CHC patients the concentrations of H-GSH, P-GSH, L-GSH, and E-GSH were reduced, whereas MDA levels were increased with a statistically significant difference (P < 0.001). CVc was significantly reduced in patients with CHC (especially in those who were HIV-positive) and correlated significantly with the values of H-GSH, P-GSH, L-GSH, E-GSH, and MDA (P < 0.001).


CONCLUSIONS
A dysfunction of the cardiac vagal system may be detected in patients with CHC (especially in those who are HIV-positive); this abnormality may be related to a reduced response to oxidative stress because of a systemic depletion of GSH.
Barbaro
G
G
Dept. of Emergency Medicine, La Sapienza University, Rome, Italy.
Di Lorenzo
G
G
Soldini
M
M
Bellomo
G
G
Belloni
G
G
Grisorio
B
B
Barbarini
G
G
D000328:Adult; D004562:Electrocardiography; D004912:Erythrocytes / Q000737:chemistry / Q000378:metabolism; D005260:Female; D005978:Glutathione / Q000172:deficiency*; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006521:Hepatitis, Chronic / Q000150:complications*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D009431:Neural Conduction / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D014630:Vagus Nerve / Q000503:physiopathology*
D008315:Malondialdehyde; D005978:Glutathione