Vitamin D and the racial difference in the genotype 1 chronic hepatitis C treatment response

Weintraub, Steven J.; Fleckenstein, Jacquelyn; Marion, Tony N.; Madey, M.A.; Mahmoudi, Tahar M.; Schechtman, Kenneth B.

doi:10.3945/ajcn.112.039974

Cited by 25 publications

(29 citation statements)

References 42 publications

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“…While some studies found an independent association between a higher baseline 25(OH)D level and SVR in HCV genotype 1/4/5 infection [5][6][7] and genotype 2/3 infection [8], others failed to find any relationship between baseline vitamin D level and treatment response [9][10][11]. These discordant results have led to uncertainty whether the baseline vitamin D level has any influence on SVR to PEG-IFN plus RBV antiviral therapy in chronic HCV infection.…”

Section: Introductionmentioning

confidence: 91%

See 1 more Smart Citation

Vitamin D level and sustained virologic response to interferon-based antiviral therapy in chronic hepatitis C: A systematic review and meta-analysis

Kitson

Sarrazin

Toniutto

et al. 2014

Journal of Hepatology

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Section: Introductionmentioning

confidence: 91%

“…Therefore, 11 studies, comprised of 7 published articles [5][6][7][8][9][10][11] and 4 conference abstracts [20][21][22][23], involving 2605 patients with chronic HCV infection, were included in the meta-analysis (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

Vitamin D level and sustained virologic response to interferon-based antiviral therapy in chronic hepatitis C: A systematic review and meta-analysis

Kitson

Sarrazin

Toniutto

et al. 2014

Journal of Hepatology

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“…Three studies (Amanzada et al, 2013;Kitson et al, 2013;Petta et al, 2013) included patients with chronic hepatitis C genotype 1 infection, one (Lange et al, 2011) with chronic hepatitis C genotype 1, 2, or 3-infection, one (White et al, 2013) with chronic hepatitis C genotype 1, 2, 3, or 4-infection, and one (Arteh et al, 2010) did not specify the kind of HCV type. Four studies (Baur et al, 2012;Corey et al, 2012;Weintraub et al, 2012;Ladero et al, 2013) were excluded because they did not report usable data. One study (Petta et al, 2010) was excluded because it reported on the same author.…”

Section: G1mentioning

confidence: 99%

Association between serum vitamin D and severity of liver fibrosis in chronic hepatitis C patients: a systematic meta-analysis

Luo

Ling

et al. 2014

J. Zhejiang Univ. Sci. B

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Abstract:To conduct a systematic review of group studies assessing the association of serum vitamin D status with the severity of liver fibrosis in chronic hepatitis C patients using meta-analysis. The relevant research literatures were identified by searching PubMed and EMBASE databases prior to October 2013 with no restrictions. We included group studies that reported odds ratio (OR) estimates with 95% confidence intervals (CIs) or a mean with standard deviation (SD) for the association between serum vitamin D status and the severity of liver fibrosis in chronic hepatitis C patients. Approximately 8321 participants from several countries were included in this analysis. Six studies on serum vitamin D status and the severity of liver fibrosis were included in this meta-analysis. ORs with 95% CIs were extracted from four studies and the pooled ORs were 0.866 (95% CI, 0.649 to 1.157). The means with SDs were extracted from three studies and the pooled means were −0.487 (95% CI, −0.659 to −0.315). There was statistically significant heterogeneity among the mean data extracted studies (P=0.029; I 2 =71.8%) but not among the OR data extracted studies (P=0.061; I 2 =55.6%). Finally, results from the mean data extracted studies suggest that lower serum vitamin D is a risk factor for the severity of liver fibrosis in chronic hepatitis C patients. However, there is no conclusive evidence on this association because of inconsistencies between the OR data extracted studies and the mean data extracted studies.

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“…age and sex), IFNL4 genotype, which was not available in previous studies, and a comprehensive suite of systematically measured clinical markers of liver disease. Moreover, only one previous study considered the association of vitamin D and SVR separately among African Americans [50]; this cross-sectional study by Weintraub et al, which included 106 African Americans and 65 whites who were chronically infected with HCV genotype 1, did not adjust for potential confounding factors and pretreatment serum was not available for all patients. Similar to our findings, Weintraub et al, found no evidence of an association between vitamin D status and SVR following PEG-IFNα/RBV therapy among African Americans.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status and Virologic Response to HCV Therapy in the HALT-C and VIRAHEP-C Trials

et al. 2016

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More than 150 million people worldwide are chronically infected with hepatitis C virus (HCV) and face higher risk of cirrhosis and hepatocellular carcinoma. Highly effective HCV treatments have recently been developed; however, they are costly and therefore poorly suited for application in resource-limited settings where HCV burden is high. Pegylated-interferon alpha (PEG-IFNα) and ribavirin (RBV) therapy is far less costly, but also less effective. Vitamin D supplementation has been proposed as an inexpensive adjuvant to treatment, however, prior epidemiological evidence on its effectiveness is inconsistent, with little data available among African Americans who naturally have lower vitamin D concentrations. We thus evaluated associations between baseline vitamin D status, measured by circulating 25-hydroxyvitamin D (25(OH)D), which is considered to be the best marker of vitamin D status in humans, and subsequent response to PEG-IFNα/RBV therapy in two large clinical trials that together included 1292 patients infected with HCV genotype 1. We used race-stratified logistic regression models to evaluate multivariable-adjusted associations of 25(OH)D with early virologic response (EVR; 2-log10 HCV RNA decline at week 12) and sustained virologic response (SVR). Among African Americans, we saw no associations. Among European Americans, we saw no association with low vitamin D (≤20 ng/mL) versus sufficient concentrations (20-<30 ng/mL). However, patients with 25(OH)D ≥30 ng/mL were actually less likely to attain EVR (OR = 0.64, 95% CI = 0.43–0.94) than those with sufficient concentrations, with a similar but non-significant association observed for SVR (OR = 0.49, 95% CI = 0.20–1.17).ConclusionHigher vitamin D status was not beneficially associated with responses to therapy; if anything, patients with higher vitamin D concentrations were less likely to attain SVR. Our data do not support a role for vitamin D supplementation as an adjuvant therapy for HCV.

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Vitamin D and the racial difference in the genotype 1 chronic hepatitis C treatment response

Abstract: Racial differences in vitamin D physiology or race-specific factors that modify the effects of vitamin D may affect the immune response to genotype 1 hepatitis C virus.

Cited by 25 publications

References 42 publications

Vitamin D level and sustained virologic response to interferon-based antiviral therapy in chronic hepatitis C: A systematic review and meta-analysis

Vitamin D level and sustained virologic response to interferon-based antiviral therapy in chronic hepatitis C: A systematic review and meta-analysis

Association between serum vitamin D and severity of liver fibrosis in chronic hepatitis C patients: a systematic meta-analysis

Vitamin D Status and Virologic Response to HCV Therapy in the HALT-C and VIRAHEP-C Trials

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