Autonomic impairment in treatment-naive patients with chronic hepatitis B and C infections

Chih-Cheng Huang; Keng-Liang Wu; Jia-Shou Liu; Yung-Yee Chang

doi:10.1016/j.autneu.2021.102928

Autonomic impairment in treatment-naive patients with chronic hepatitis B and C infections

Auton Neurosci. 2022 Mar:238:102928. doi: 10.1016/j.autneu.2021.102928. Epub 2021 Dec 13.

Authors

Chih-Cheng Huang¹, Keng-Liang Wu², Jia-Shou Liu¹, Yung-Yee Chang³

Affiliations

¹ Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
² Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
³ Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan. Electronic address: changyy7@gmail.com.

PMID: 35021146
DOI: 10.1016/j.autneu.2021.102928

Abstract

Background: Peripheral neuropathy is not an uncommon manifestation in patients with chronic hepatitis. The role of cryoglobulin (CG) in neuropathy in patients with chronic hepatitis remains controversial. There is limited information about the autonomic neuropathy in chronic hepatitis. This study aimed to evaluate autonomic function in treatment-naive patients with chronic hepatitis B or hepatitis C infection and to elucidate the association between autonomic neuropathy and CG in these patients.

Methods: A total of 29 treatment-naive patients with chronic, yet mild degrees of hepatitis B or C infection were evaluated for autonomic function, including those in the sympathetic sudomotor, cardiovagal, and adrenergic domains, to compare with the control subjects. The autonomic impairment was graded using the Composite Autonomic Scoring Scale. Then, association analyses between autonomic parameters/scores and CG were performed.

Results: Patients with chronic hepatitis B or C infection had significantly worse autonomic function than control subjects, especially in the sudomotor and cardiovagal domains. The autonomic manifestations in cases with and without CG were similar. There was no significant difference in autonomic dysfunction between patients with hepatitis B and C infections.

Conclusion: The study demonstrated that autonomic neuropathy was not uncommon in patients with chronic hepatitis B or C infection. There was no association between autonomic neuropathy and CG.

Keywords: Autonomic function; Cryoglobulinemia; Hepatitis B infection; Hepatitis C infection.