Chronic hepatitis C virus infection associated with autonomic dysfunction

Osztovits, Janos; Horváth, Tamás; Abonyi, Margit; Tóth, Tamás; Visnyei, Z; Bekő, Gabriella; Csák, Tímea; Lakatos, László; Littvay, Levente; Fehér, János; Kempler, Péter; Kollai, Márk; Szalay, Ferenç

doi:10.1111/j.1478-3231.2009.02075.x

Cited by 31 publications

(29 citation statements)

References 33 publications

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“…VM was abnormal in 58.3% of patients. Autonomic tests results are summarized in There is five other reports [3][4][5][6][7] focusing autonomic function in HCV-infected patients. They did not included cases with sensory polyneuropathy neither made large ACT tests.…”

Section: Resultsmentioning

confidence: 99%

“…These authors detected dysfunction of the cardiac vagal system especially in patients with HIV and HCV coinfection, associated with depletion of glutathione. A multivariate analysis of 45 HCV-infected patients and 40 controls subjects showed that autonomic dysfunction in the former group was not associated with serum HCV RNA levels and cryoglobulins 7 . We can consider that HCV-infected patients with sensory polyneuropathy and complaint of dizziness support the needed of autonomic cardiovascular function investigation.…”

Section: Resultsmentioning

confidence: 99%

“…It seems that there is no direct tissues lesion by the virus, but probably an immune response against the virus could develop the disease. There are few reports focusing the relation between the HCV and dysautonomia [3][4][5][6][7] . Our objective was to report the autonomic cardiovascular function in HCVinfected Brazilian patients with sensory small-fiber neuropathy.…”

Section: Autonomic Evaluation Of Hepatitis C Virus Infected Patientsmentioning

confidence: 99%

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Autonomic evaluation of hepatitis C virus infected patients

Coutinho¹,

Bordalo²,

Nascimento³

2013

Arq. Neuro-Psiquiatr.

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Hepatitis C virus (HCV) affects 170 million people all over the world. In Brazil, the incidence of HCV-infected individuals is 5.1/100,000 habitants. The highest prevalence is seen in Acre State, in the Brazilian Amazon (22.7/100,000 habitants) 1 . HCVinfection has been associated with neurological manifestations, including peripheral neuropathy. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and distal sensory polyneuropathy have been reported. HCV-infection associated with central nervous system vasculitis was also referred. About 65% of infected patients are around 30 to 49 years old of age, and 30% will develop hepatocellular carcinoma. The physiopathology basis is still unknown 2 . It seems that there is no direct tissues lesion by the virus, but probably an immune response against the virus could develop the disease. There are few reports focusing the relation between the HCV and dysautonomia [3][4][5][6][7] . Our objective was to report the autonomic cardiovascular function in HCVinfected Brazilian patients with sensory small-fiber neuropathy. METHODSWe have included 12 consecutive HCV-infected patients with sensory small-fiber polyneuropathy. Patients were randomly selected from a cohort of more than 60 HCV patients followed in the Hepatitis Reference Center (Dr. Bordalo) of Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, Brazil. Patients with diabetes, arterial hypertension, severe liver dysfunction, other infections, including HIV and HTLV, use of ABSTRACTThere are few studies reporting the association between hepatitis C virus (HCV) infection and disautonomia. We have evaluated the autonomic cardiovascular function in 12 patients with sensory small-fiber polyneuropathy infected by HCV. The mean age was 49±13 years old. The mean infection time was 9.6 years in six (50%) patients. Thermal and pinprick hypoesthesia was observed in distal legs in all patients. Autonomic symptoms were referred by eight (66.7%) patients. Among patients with abnormal autonomic cardiovascular test, five (41.7%) showed abnormal results in two or more tests. Valsalva maneuver was abnormal in seven (58.3%) patients. We can consider that there is an association of both parasympathetic and sympathetic efferent cardiovascular dysfunction in this group of patients.Key words: hepatitis C, dysautonomia, small-fiber polyneuropathy. RESUMOExistem poucos estudos que relatam a associação entre infecção pelo vírus da hepatite C (HCV) e disautonomia. Avaliamos a função autonômica cardiovascular em 12 pacientes com polineuropatia de fibras finas e infectados pelo HCV. A idade média foi de 49±13 anos. O tempo de infecção média foi de 9,6 anos em seis (50%) pacientes. Hipoestesia termoalgésica foi observada nos segmentos distais das pernas em todos os pacientes. Sintomas autonômicos foram relatados por oito (66,7%) pacientes. No teste autonômico cardiovascular, cinco (41,7%) apresentaram resultados anormais em dois ou mais testes. Manobra de Valsalva foi anormal em sete (58,3%) pacientes. Podemos considerar qu...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Autonomic Evaluation Of Hepatitis C Virus Infected Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Autonomic evaluation of hepatitis C virus infected patients

Coutinho¹,

Bordalo²,

Nascimento³

2013

Arq. Neuro-Psiquiatr.

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“…In addition, autonomic dysfunction is frequently seen in patients with various levels of liver disease [53], including early stages [54][55][56][57][58][59], and may manifest as frequent falls, blackouts, orthostatic hypotension, and syncope. It has also been linked to sudden cardiac death and mortality [53].…”

Section: Cardiac and Autonomic Abnormalitiesmentioning

confidence: 99%

Quality of life and symptom management

Abdo

Sanai

2015

Cirrhosis: A Practical Guide to Management

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“…Auch die Infektion mit dem Hepatitis-C-Virus kann mit Schädigungen des zentralen, peripheren und autonomen Nervensystems einhergehen [1,14,17,19,24]. Am besten etabliert ist die Verbindung der HCV-assoziierten Neuropathie mit der Kryoglobulinämie [14,17], in vielen Fällen ist die Pathogenese aber noch unklar.…”

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Achalasia in a patient with HIV/HCV coinfection

Gockel

Drescher

et al. 2011

Chirurg

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Esophageal involvement in the context of opportunistic infections in human immunodeficiency virus (HIV) positive patients is a frequent phenomenon. However, worldwide esophageal achalasia has been described only twice in HIV-infected patients.We report the case of a 44-year-old Caucasian patient with HIV and Hepatitis C virus (HIV/HCV) coinfection who, within 2.5 years, displayed a progressive symptomatology with dysphagia, retrosternal pain, regurgitation as well as a considerable loss of weight before achalasia was finally diagnosed. Treatment was performed primarily surgically by means of laparoscopic Heller myotomy with an anterior 180° semifundoplication according to Dor.Histopathology of the specimens taken from the lower esophageal sphincter high-pressure zone proved alterations with abundant connective tissue and only scarce parts of the smooth muscular system without inflammatory infiltrations. In addition, the ganglia cells of the myenteric plexus as well as the interstitial cells of Cajal were significantly reduced. Interestingly, specific gene sequences of the hepatitis C virus could be detected in the esophageal tissue specimen. In contrast, analysis of specific HIV-gene sequences in the same tissue revealed a negative result.The possible but previously unknown relationship between esophageal achalasia and coinfection with HIV and HCV, also described as neurotropic viruses, will be discussed.

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Chronic hepatitis C virus infection associated with autonomic dysfunction

Abstract: Our results suggest that impaired autonomic function is caused by chronic HCV infection. Further studies are needed, however, to identify the underlying mechanisms.

Cited by 31 publications

References 33 publications

Autonomic evaluation of hepatitis C virus infected patients

Autonomic evaluation of hepatitis C virus infected patients

Quality of life and symptom management

Achalasia in a patient with HIV/HCV coinfection

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