Klinikum der J.W. Goethe-Universität Frankfurt am Main, Medizinische Klinik 1, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
J Hepatol. 2011 May;54(5):887-93. doi: 10.1016/j.jhep.2010.08.036. Epub 2011 Jan 20.
BACKGROUND & AIMS: Vitamin D is an important immune modulator and preliminary data indicated an association between vitamin D deficiency and sustained virologic response (SVR) rates in hepatitis C virus (HCV) genotype 1 patients. We, therefore, performed a comprehensive analysis on the impact of vitamin D serum levels and of genetic polymorphisms with functional relevance within the vitamin D cascade on chronic hepatitis C and its treatment.
Vitamin D serum levels, genetic polymorphisms within the vitamin D receptor and 1α-hydroxylase were determined in a cohort of 468 HCV genotype 1, 2, and 3 infected patients who were treated with interferon-alfa based regimens.
Chronic hepatitis C was associated with a high incidence of severe vitamin D deficiency compared to controls (25(OH)D(3)<10 ng/ml in 25% versus 12%, p<0.00001). 25(OH)D(3) deficiency correlated with SVR in HCV genotype 2 and 3 patients (50% and 81% SVR for patients with and without severe vitamin D deficiency, respectively, p<0.0001). In addition, the CYP27B1-1260 promoter polymorphism rs10877012 had substantial impact on 1,25-dihydroxyvitamin D serum levels (72, 61, and 60 pmol/ml for rs10877012 AA, AC, and CC, respectively, p=0.04) and on SVR rates in HCV genotype 1, 2, and 3 infected patients (77% and 65% versus 42% for rs10877012 AA, AC, and CC, respectively, p=0.02).
Chronic hepatitis C virus infection is associated with vitamin D deficiency. Reduced 25-hydroxyvitamin D levels and CYP27B1-1260 promoter polymorphism leading to reduced 1,25-dihydroxyvitamin D levels are associated with failure to achieve SVR in HCV genotype 1, 2, and 3 infected patients.
维生素 D 是一种重要的免疫调节剂，初步数据表明维生素 D 缺乏与丙型肝炎病毒（HCV）基因型 1 患者的持续病毒学应答（SVR）率之间存在关联。因此，我们对维生素 D 血清水平以及维生素 D 级联中具有功能相关性的基因多态性对慢性丙型肝炎及其治疗的影响进行了综合分析。
在接受干扰素-α为基础方案治疗的 468 例 HCV 基因型 1、2 和 3 感染患者的队列中，测定了维生素 D 血清水平、维生素 D 受体和 1α-羟化酶的基因多态性。
与对照组相比，慢性丙型肝炎患者维生素 D 严重缺乏的发生率较高（25（OH）D（3）<10ng/ml 为 25%，而对照组为 12%，p<0.00001）。25（OH）D（3）缺乏与 HCV 基因型 2 和 3 患者的 SVR 相关（维生素 D 严重缺乏的患者 SVR 分别为 50%和 81%，p<0.0001）。此外，CYP27B1-1260 启动子多态性 rs10877012 对 1,25-二羟维生素 D 血清水平有显著影响（rs10877012AA、AC 和 CC 的 1,25-二羟维生素 D 血清水平分别为 72、61 和 60pmol/ml，p=0.04），并影响 HCV 基因型 1、2 和 3 感染患者的 SVR 率（rs10877012AA、AC 和 CC 的 SVR 率分别为 77%和 65%，而 42%，p=0.02）。
慢性丙型肝炎病毒感染与维生素 D 缺乏有关。25-羟维生素 D 水平降低和 CYP27B1-1260 启动子多态性导致 1,25-二羟维生素 D 水平降低与 HCV 基因型 1、2 和 3 感染患者未能达到 SVR 有关。
