Chronic hepatitis C virus infection associated with autonomic dysfunction.
BACKGROUND
Impaired autonomic function has been described in patients with chronic liver diseases from different aetiologies, and has proven to be a poor prognostic indicator. To date, it is not known how chronic hepatitis C virus (HCV) infection affects the autonomic nervous system.


OBJECTIVE
In the present study, we compared cardiovagal autonomic function in patients with chronic HCV infection and healthy controls and examined the relation between autonomic function and serum levels of aminotransferases, HCV RNA, cryoglobulins, albumin and glucose.


METHODS
Autonomic function was assessed in 45 treatment-naïve patients with chronic HCV infection and in 40 healthy controls by determining spontaneous baroreflex sensitivity (BRS) and heart rate variability (HRV) indices. The R-R interval was determined by electrocardiogram recording; continuous radial artery pressure was monitored simultaneously by applanation tonometry. Laboratory analyses and quantitative polymerase chain reaction for serum HCV RNA level were performed by standard procedures.


RESULTS
BRS and HRV time and frequency domain indices were lower in patients with HCV infection compared with healthy controls [7.1+/-3.4 vs. 11.5+/-6.5 ms/mmHg for BRS, 168.5+/-160.9 vs. 370.7+/-349.4 ms(2) for low-frequency HRV (mean+/-SD); P<0.01]. Multivariate analysis showed that autonomic dysfunction in HCV-infected patients correlated with elevated alanine aminotransferase levels, but was not associated with serum HCV RNA levels and cryoglobulins.


CONCLUSIONS
Our results suggest that impaired autonomic function is caused by chronic HCV infection. Further studies are needed, however, to identify the underlying mechanisms.
Osztovits
János
J
1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary. janos.osztovits@gmail.com
Horváth
Tamás
T
Abonyi
Margit
M
Tóth
Tamás
T
Visnyei
Zsolt
Z
Bekö
Gabriella
G
Csák
Tímea
T
Lakatos
Péter László
PL
Littvay
Levente
L
Fehér
János
J
Kempler
Péter
P
Kollai
Márk
M
Szalay
Ferenc
F
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000209:etiology*; D017704:Baroreflex; D016022:Case-Control Studies; D005260:Female; D006339:Heart Rate; D019698:Hepatitis C, Chronic / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood
D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase