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25-Vitamin D levels in chronic hepatitis C infection: association with cirrhosis and sustained virologic response.
Ann Gastroenterol 2017; 30(3):344-348AG

Abstract

BACKGROUND

Low serum 25-Vitamin D levels are associated with advanced fibrosis in hepatitis C infection. Vitamin D supplementation has been hypothesized to augment response rates to interferon-based therapy. To date, no investigation has evaluated vitamin D levels during direct-acting antiviral therapy. We aimed to evaluate the prevalence of vitamin D deficiency in cirrhotic and non-cirrhotic cohorts, the predictive value of pretreatment levels for a sustained virologic response, and the changes in 25-OH vitamin D levels during direct-acting antiviral therapy.

METHODS

Two hundred eighteen patients with chronic hepatitis C who completed direct-acting antiviral therapy were consecutively enrolled. Vitamin D levels were measured using chemiluminescence immunoassay, prior to initiation and at completion of therapy. Advanced liver fibrosis (cirrhosis) was determined by biopsy, FibroSURE blood test, or imaging.

RESULTS

A sustained virologic response was achieved in 79% (n=172) of patients, with 19% (n=44) relapsing. A total of 123 (56.4%) patients were cirrhotic. The prevalence of Vitamin D deficiency (10-20 ng/mL) and severe deficiency (<10 ng/mL) was significantly higher in cirrhotic patients (P=0.04). Pre-treatment vitamin D levels in cirrhotic patients were negatively correlated with Model for End-Stage Liver Disease score, total bilirubin and INR (P<0.05). Neither pretreatment vitamin D level nor the change during therapy was associated with an increased rate of sustained virologic response.

CONCLUSIONS

The prevalence of vitamin D deficiency is higher in hepatitis-C-related cirrhotic cohorts compared to non-cirrhotic patients and correlates with components of hepatic function. Neither pretreatment vitamin D level nor the change during therapy was associated with an increased rate of sustained virologic response.

Authors+Show Affiliations

Banner University Liver Disease Center, University of Arizona College of Medicine Phoenix.Banner University Liver Disease Center, University of Arizona College of Medicine Phoenix.Banner University Liver Disease Center, University of Arizona College of Medicine Phoenix.Banner University Liver Disease Center, University of Arizona College of Medicine Phoenix.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28469365

Citation

Backstedt, David, et al. "25-Vitamin D Levels in Chronic Hepatitis C Infection: Association With Cirrhosis and Sustained Virologic Response." Annals of Gastroenterology, vol. 30, no. 3, 2017, pp. 344-348.
Backstedt D, Pedersen M, Choi M, et al. 25-Vitamin D levels in chronic hepatitis C infection: association with cirrhosis and sustained virologic response. Ann Gastroenterol. 2017;30(3):344-348.
Backstedt, D., Pedersen, M., Choi, M., & Seetharam, A. (2017). 25-Vitamin D levels in chronic hepatitis C infection: association with cirrhosis and sustained virologic response. Annals of Gastroenterology, 30(3), pp. 344-348. doi:10.20524/aog.2017.0120.
Backstedt D, et al. 25-Vitamin D Levels in Chronic Hepatitis C Infection: Association With Cirrhosis and Sustained Virologic Response. Ann Gastroenterol. 2017;30(3):344-348. PubMed PMID: 28469365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 25-Vitamin D levels in chronic hepatitis C infection: association with cirrhosis and sustained virologic response. AU - Backstedt,David, AU - Pedersen,Mark, AU - Choi,Myunghan, AU - Seetharam,Anil, Y1 - 2017/01/05/ PY - 2016/07/10/received PY - 2016/12/03/accepted PY - 2017/5/5/entrez PY - 2017/5/5/pubmed PY - 2017/5/5/medline KW - 25-OH vitamin D KW - Hepatitis C KW - direct acting antiviral KW - sustained virologic response KW - vitamin D SP - 344 EP - 348 JF - Annals of gastroenterology JO - Ann Gastroenterol VL - 30 IS - 3 N2 - BACKGROUND: Low serum 25-Vitamin D levels are associated with advanced fibrosis in hepatitis C infection. Vitamin D supplementation has been hypothesized to augment response rates to interferon-based therapy. To date, no investigation has evaluated vitamin D levels during direct-acting antiviral therapy. We aimed to evaluate the prevalence of vitamin D deficiency in cirrhotic and non-cirrhotic cohorts, the predictive value of pretreatment levels for a sustained virologic response, and the changes in 25-OH vitamin D levels during direct-acting antiviral therapy. METHODS: Two hundred eighteen patients with chronic hepatitis C who completed direct-acting antiviral therapy were consecutively enrolled. Vitamin D levels were measured using chemiluminescence immunoassay, prior to initiation and at completion of therapy. Advanced liver fibrosis (cirrhosis) was determined by biopsy, FibroSURE blood test, or imaging. RESULTS: A sustained virologic response was achieved in 79% (n=172) of patients, with 19% (n=44) relapsing. A total of 123 (56.4%) patients were cirrhotic. The prevalence of Vitamin D deficiency (10-20 ng/mL) and severe deficiency (<10 ng/mL) was significantly higher in cirrhotic patients (P=0.04). Pre-treatment vitamin D levels in cirrhotic patients were negatively correlated with Model for End-Stage Liver Disease score, total bilirubin and INR (P<0.05). Neither pretreatment vitamin D level nor the change during therapy was associated with an increased rate of sustained virologic response. CONCLUSIONS: The prevalence of vitamin D deficiency is higher in hepatitis-C-related cirrhotic cohorts compared to non-cirrhotic patients and correlates with components of hepatic function. Neither pretreatment vitamin D level nor the change during therapy was associated with an increased rate of sustained virologic response. SN - 1108-7471 UR - https://www.unboundmedicine.com/medline/citation/28469365/25_Vitamin_D_levels_in_chronic_hepatitis_C_infection:_association_with_cirrhosis_and_sustained_virologic_response_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28469365/ DB - PRIME DP - Unbound Medicine ER -