55 Vitamin D Supplement Improves SVR in Chronic Hepatitis C (Genotype 1) Naive Patients Treated With Peg Interferon and Ribavirin

Mouch, Saif Abu; Fireman, Zvi; Jarchovsky, J; Assy, Nimer

doi:10.1016/s0168-8278(10)60057-8

Cited by 22 publications

(20 citation statements)

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“…Even so, these findings are consistent with previous results, indicating that vitamin D inadequacy is common in non-cholestatic chronic liver diseases and correlates with disease severity (Babbs et al, 1988;Fisher and Fisher, 2007). In other earlier studies, a deficient vitamin D status was linked to severe fibrosis and low sustained virologic responses (SVR) during interferon (IFN)-g-based therapies (Abu Mouch et al, 2010;Petta et al, 2010).…”

Section: Discussionsupporting

confidence: 91%

Circulating IL-6, IL-17 and vitamin D in hepatocellular carcinoma: Potential biomarkers for a more favorable prognosis?

Hammad¹,

Abdelraouf²,

Hassanein

et al. 2013

Journal of Immunotoxicology

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Hepatitis C virus (HCV) infects primarily hepatocytes, leads to development of fibrosis and/or cirrhosis of the liver and is a significant factor for developing hepatocellular carcinoma (HCC). Evidence indicates that liver fibrosis contains uncontrolled inflammation as a part of its etiology. Normal cell-mediated immunity plays a central role in the mechanisms involved in viral clearance/persistence in the liver. In this context, cytokines modulate the immune system and exert direct anti-viral activity. To this end, this study investigated potential associations of serum IL-17 and IL-6 with exacerbation of hepatic damage in chronic HCV patients to determine their utility as prognostic markers for potential development of HCC. Chronic HCV-patients were recruited, divided into groups according to degree of liver damage, i.e. patients with perihepatic fibrosis, hepatic cirrhosis, or HCC, and had their blood collected for analysis of liver function and serum IL-6 and IL-17 levels. Interestingly, increases in serum IL-17 levels in the study groups were associated with aggravation of the clinical state from HCV to cirrhosis and then to HCC. Serum IL-6 levels followed a similar pattern. The association of both cytokines with progressive exacerbation of the initial HCV-induced liver damage was further confirmed by correlation analysis that revealed positive correlations between HCV RNA titer and IL-17 (þ0.951, p50.05) and IL-6 (þ0.85, p50.05). A receiver operating characteristics (ROC) analysis revealed their beneficial addition as promising biomarkers for a better prognostic profile of HCC. Interestingly, a significant progressive decline in the active vitamin D status was noted in all three clinical states, and these too were associated with progressive liver disease. This study confirms the necessity of adding screening for IL-6 and IL-17 and vitamin D to that of the classic marker AFP for patients with HCV and cirrhosis to hopefully permit clinicians to initiate measures that ultimately might mitigate/delay development of HCC in these infected patients.

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Section: Discussionsupporting

confidence: 91%

Circulating IL-6, IL-17 and vitamin D in hepatocellular carcinoma: Potential biomarkers for a more favorable prognosis?

Hammad¹,

Abdelraouf²,

Hassanein

et al. 2013

Journal of Immunotoxicology

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“…[10] Upon learning of these results, Project ECHO checked vitamin D levels among its hepatitis C patients across the state and found that approximately 85 percent were deficient. The clinician leadership rapidly instituted a protocol adding vitamin D to antiviral therapy and deployed it among the project’s participating providers.…”

Section: How the Model Workmentioning

confidence: 99%

Partnering Urban Academic Medical Centers And Rural Primary Care Clinicians To Provide Complex Chronic Disease Care

Kalishman²,

et al. 2011

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Many of the estimated thirty-two million Americans expected to gain coverage under the Affordable Care Act are likely to have high levels of unmet need for various chronic illnesses and to live in areas that are already underserved. In New Mexico an innovative new model of health care education and delivery known as Project ECHO (Extension for Community Healthcare Outcomes) provides high-quality primary and specialty care to a comparable population. Using state-of-the-art telehealth technology and case-based learning, Project ECHO enables specialists at the University of New Mexico Health Sciences Center to partner with primary care clinicians in underserved areas to deliver complex specialty care to patients with hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity and mental illness. As of March 2011, 298 Project ECHO teams across New Mexico have delivered more than 10,000 specialty care consultations for hepatitis C and other chronic diseases.

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“…Based on the relationship between follow-up viral response rates and baseline 25(OH)D serum level, Bitetto et al10 suggested that vitamin D plays an important role in early HCV decline after antiviral treatment. In two reports about additional effect of vitamin D on SVR in patients with CHC, Abu Mouth et al18 showed vitamin D supplementation to Peg/RBV treatment significantly improved SVR in naïve genotype 1 patients (86% versus 43%, P <0.001), and Bitetto et al12 showed the increase of SVR to antiviral treatment for recurrent hepatitis C (5/18 versus 5/27, P <0.02). The latter two studies have limited value due to small number of patients.…”

mentioning

confidence: 99%

Role of vitamin D in chronic hepatitis C

Kim

2011

Korean J Hepatol

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55 Vitamin D Supplement Improves SVR in Chronic Hepatitis C (Genotype 1) Naive Patients Treated With Peg Interferon and Ribavirin

Cited by 22 publications

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Circulating IL-6, IL-17 and vitamin D in hepatocellular carcinoma: Potential biomarkers for a more favorable prognosis?

Circulating IL-6, IL-17 and vitamin D in hepatocellular carcinoma: Potential biomarkers for a more favorable prognosis?

Partnering Urban Academic Medical Centers And Rural Primary Care Clinicians To Provide Complex Chronic Disease Care

Role of vitamin D in chronic hepatitis C

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