title: Reversible autonomic dysfunction during antiviral treatment in patients with chronic hepatitis C virus infection: Anti-HCV therapy and autonomic function.
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.
  
  
  OBJECTIVE
  In the present prospective study, we analyzed the changes of autonomic function during anti-HCV treatment.
  
  
  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.
authors.affiliation: First Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Janos
authors.initials: J
authors.lastname: Osztovits
authors.forename: Evelin
authors.initials: E
authors.lastname: Horvath
authors.forename: Judit
authors.initials: J
authors.lastname: Tax
authors.forename: Levente
authors.initials: L
authors.lastname: Csihi
authors.forename: Tamas
authors.initials: T
authors.lastname: Horvath
authors.forename: Levente
authors.initials: L
authors.lastname: Littvay
authors.forename: Tamas
authors.initials: T
authors.lastname: Toth
authors.forename: Margit
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authors.lastname: Abonyi
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authors.lastname: Lakatos
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authors.lastname: Kollai
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authors.lastname: Feher
authors.forename: Ferenc
authors.initials: F
authors.lastname: Szalay
authors.forename: Hubert E
authors.initials: HE
authors.lastname: Blum
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