Low vitamin D serum concentration is associated with high levels of hepatitis B virus replication in chronically infected patients

Abstract

Vitamin D is an important immune modulator that plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). In contrast, the relationship between vitamin D metabolism and chronic hepatitis B (CHB) is less well characterized. Therefore, we quantified 25(OH)D 3 serum levels in a cohort of 203 treatmentna€ ıve patients with chronic hepatitis B virus (HBV) infection and tested for their association with clinical parameters of CHB. Of 203 patients, 69 (34%), 95 (47%), and 39 (19%) had severe vitamin D deficiency (25(OH)D 3 <10 ng/mL), vitamin D insufficiency (25(OH)D 3 10 and <20 ng/mL), or adequate vitamin D serum levels (25(OH)D 3 20 ng/mL), respectively. In both uni-and multivariate analyses, HBV DNA viral load (log 10 IU/mL) was a strong predictor of low 25(OH)D 3 serum levels (P 5 0.0007 and P 5 0.000048, respectively) and vice versa. Mean 25(OH)D 3 serum concentrations in patients with HBV DNA <2,000 versus 2,000 IU/mL were 17 versus 11 ng/mL, respectively (P < 0.00001). In addition, hepatitis B early antigen (HBeAg)-positive patients had lower 25(OH)D 3 serum levels than HBeAg-negative patients (P 5 0.0013). Finally, 25(OH)D 3 and HBV DNA serum levels showed inverse seasonal fluctuations. Conclusion: Low 25(OH)D 3 serum levels are associated with high levels of HBV replication in patients with CHB. This represents a major difference from chronic hepatitis C, where numerous previous studies have shown a lack of correlation between HCV viral load and vitamin D serum levels. Inverse seasonal fluctuations of 25(OH)D 3 and HBV DNA serum levels are suggestive of a functional relationship between both variables. (HEPATOLOGY 2013;58:1270-1276

Levels of Interleukin-17 and Vitamin D and Their Correlation in Viral Hepatitis Patients

“…[21], [22] Also reported that vitamin D levels were not related to HCV load in patients (p= 0.903) which consolidates the current result. Results show that weak correlations were accounted with no significance at P>0.05 between studied parameters in control group, while within patients group, strong, highly significant and positive correlations were accounted between Calcitriol (1,25 dihydroxy Vit.…”

Vitamin D levels in patients with chronic hepatitis B

“…We read with interest the article by Farnik et al 1 regarding the low vitamin D levels in patients with chronic hepatitis B virus (HBV). A remarkable finding was the inverse relationship between serum vitamin D levels and HBV viral load.…”

“…1 However, it is not clear whether HCV treatment uptake increased since the availability of BOC and TVR. We surveyed prescription activity in the USA after the FDA approval of BOC and TVR, using proprietary databases (see online methods).…”

Serum vitamin D levels in treatment-naïve chronic hepatitis B patients

“…Due to its immunomodulatory role, there is growing evidence about the interrelationship between vitamin D and different chronic liver diseases in different stages. [3] Different studies have shown a wide, universal agreement of vitamin D deficiency in patients with chronic hepatitis C virus (HCV) infection, [4,5] chronic HBV, [6,7] nonalcoholic steatohepatitis (NASH) [8] and hepatocellular carcinoma (HCC) [9] with contradictory reports about the impact of vitamin D deficiency on disease pathology and progression.…”