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Vitamin D supplementation improves response to antiviral treatment for recurrent hepatitis C
Authors:Davide Bitetto  Carlo Fabris  Ezio Fornasiere  Corrado Pipan  Elisa Fumolo  Annarosa Cussigh  Sara Bignulin  Sara Cmet  Elisabetta Fontanini  Edmondo Falleti  Romina Martinella  Mario Pirisi  Pierluigi Toniutto
Affiliation:1. Medical Liver Transplantation Unit, Internal Medicine, University of Udine, Udine, Italy;2. Hygiene and Epidemiology, University of Udine, Udine, Italy;3. Department of Clinical and Experimental Medicine, University of Eastern Piedmont “A. Avogadro”, Novara, Italy;4. Interdisciplinary Research Center of Autoimmune Diseases, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
Abstract:In immune‐competent patients, higher vitamin D levels predicted sustained viral response (SVR) following interferon (INF) and ribavirin therapy for chronic hepatitis C. This study aimed to verify the influence of vitamin D serum levels and/or vitamin D supplementation in predicting SVR rates for recurrent hepatitis C (RHC). Forty‐two consecutive patients were treated for RHC with combination therapy with INF‐α and ribavirin for 48 weeks. Vitamin D serum levels were measured in all patients before antiviral therapy. In 15 patients oral vitamin D3 supplementation was administered to avoid further bone loss. SVR was observed in 13 patients; it was achieved in 1/10 severely vitamin D deficient (≤10 ng/ml) patients, in 6/20 deficient (>10 and ≤20 ng/ml) and in 6/12 with near normal (>20 ng/ml) 25‐OH vitamin D serum levels (P < 0.05). Cholecalciferol supplementation, in the presence of a normal or near normal baseline vitamin D concentration, (improvement of chi‐square P < 0.05, odds ratio 2.22) and possessing a genotype other than 1 (improvement of chi‐square P < 0.05, odds ratio 3.383) were the only variables independently associated to SVR. In conclusion, vitamin D deficiency predicts an unfavourable response to antiviral treatment of RHC. Vitamin D supplementation improves the probability of achieving a SVR following antiviral treatment.
Keywords:interferon  liver transplantation  recurrent hepatitis C  vitamin D
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