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Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/285: 147-151 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/285: 147-151

Title: Safety assessment of chronic hepatitis C treatment using h-FABP and 24-hour ECG Holter monitoring 

Authors: Poliwczak AR, Jędrzejczak-Pospiech K, Błaszczyk J, Białkowska-Warzecha J, Woźny J, Jabłkowski M. 

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

Safety assessment of chronic hepatitis C treatment using h-FABP and 24-hour ECG Holter monitoring

Poliwczak AR,1 Jędrzejczak-Pospiech K,1 Błaszczyk J,2 Białkowska-Warzecha J,3 Woźny J,3 Jabłkowski M3.

1Department of Human Physiology, Medical University of Lodz, Poland; 2Rehabilitation and Sport Faculty, State University of Applied Sciences of Kalisz, Poland; 3Department of Infectious and Liver Diseases, Medical University of Lodz, Poland

Every year, 3-4 million people become infected with HCV, most of them are asymptomatic. In more than 20-30 years from infection, it leads to 10-20% of patients with cirrhosis, followed by hepatocellular carcinoma. Cardiological complications of the antiviral treatment are relatively rare, but force us to take additional diagnostic or discontinuation of therapy.
The aim of study
was to assess the cardiovascular safety of chronic hepatitis C treatment of genotype 1 in a triple regimen containing pegylated interferon-α in combination with ribavirin and boceprevir based on analysis of 24-hour ECG Holer monitoring, as well as changes in the concentration of cardiac fraction of fatty acid binding proteins (h-FABP).
Material and methods
. 14 hepatitis C patients and 15 healthy people were included. The participants had an ambulatory 24-hour ECG-Holter recording at home condition and the determined level of h-FABP at baseline, after 4 and 12-16 weeks of treatment and 2 weeks after the end of therapy. The HRV parameters, AC/DC and QTc was calculated.
Results
. At baseline there were no statistically significant differences in the HRV parameters, DC/AC, and QTc-interval. Absolute DC/AC values, HRV parameters: SDNN-ix, rMSDD, TP, HF, VLF and ULF were significantly lower in the treated group. LF/HF ratio was higher in this group (p=0.047). These changes persisted during the follow-up and disappeared after treatment. QTc was the shortest in the 4th week and withdrew during further follow-up. H-FABP levels did not differ statistically significantly between any subsequent determinations.
Conclusion
. The results indicate significant cardiovascular safety when using triple therapy containing pegylated interferon-α in combination with ribavirin and boceprevir. During the therapy, autonomic imbalances appeared indicating the advantage of the sympathetic nervous system and persisted also after the end of treatment. Their role requires further observation.

Key words: chronic hepatitis C, HRV, DC/AC, cardiovascular risk, h-FABP

Pol Med J, 2020; XLVIII (285); 147–151