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

Pol Merkur Lekarski. 2020 Jun 17;48(285):147-151.

Abstract

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.

Aim: 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).

Materials 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.

Conclusions: 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.

Keywords: DC/AC; HRV; cardiovascular risk; chronic hepatitis C; h-FABP.

MeSH terms

  • Antiviral Agents / therapeutic use
  • Biomarkers / analysis
  • Electrocardiography, Ambulatory*
  • Fatty Acid Binding Protein 3 / analysis
  • Heart Rate
  • Hepatitis C, Chronic* / drug therapy
  • Humans
  • Interferon-alpha* / therapeutic use
  • Polyethylene Glycols* / therapeutic use
  • Recombinant Proteins / therapeutic use
  • Ribavirin / therapeutic use

Substances

  • Antiviral Agents
  • Biomarkers
  • Fatty Acid Binding Protein 3
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a