在 HIV/丙型肝炎病毒合并感染患者中，较高的 25-羟维生素 D 浓度与丙型肝炎病毒治疗反应无关，但与利托那韦的使用有关。

In HIV/hepatitis C virus co-infected patients, higher 25-hydroxyvitamin D concentrations were not related to hepatitis C virus treatment responses but were associated with ritonavir use.

机构信息

Divisions of Liver Diseases and Nephrology, Mount Sinai School of Medicine, New York, NY 10029, USA.

出版信息

Am J Clin Nutr. 2013 Aug;98(2):423-9. doi: 10.3945/ajcn.112.048785. Epub 2013 Jun 5.

DOI:10.3945/ajcn.112.048785

PMID:23739141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3712551/

Abstract

BACKGROUND

Among patients with hepatitis C virus (HCV) monoinfection, 25-hydroxyvitamin D [25(OH)D] concentrations are positively associated with a response to peg-interferon/ribavirin. Data on the relation between 25(OH)D concentrations and HCV treatment response in HIV-infected patients are limited.

OBJECTIVE

The objective was to determine whether baseline 25(OH)D concentrations predict virologic response in HIV/HCV co-infected patients and to examine variables associated with 25(OH)D concentrations ≥30 ng/mL.

DESIGN

Data and samples from 144 HCV genotype 1, treatment-naive patients from a completed HCV treatment trial were examined in this retrospective study. Early virologic response (EVR) was defined as ≥2 log10 reduction in HCV RNA and/or HCV RNA <600 IU/mL at week 12 of peg-interferon/ribavirin treatment. Baseline 25(OH)D was measured by liquid chromatography/tandem mass spectrometry.

RESULTS

Compared with the non-EVR control group (n = 68), the EVR group (n = 76) was younger, had fewer cirrhotic subjects, had a higher proportion with the IL28B CC genotype, had a higher albumin concentration, and had a lower HCV viral load at baseline (P ≤ 0.05). The difference in baseline 25(OH)D concentrations between EVR and non-EVR patients was not statistically significant (median: 25 ng/mL compared with 20 ng/mL; P = 0.23). Similar results were found for sustained virologic response (SVR). In multivariable analysis, white and Hispanic race-ethnicity (OR: 6.26; 95% CI: 2.47, 15.88; P = 0.0001) and ritonavir use (OR: 2.68; 95% CI: 1.08, 6.65; P = 0.033) were associated with higher 25(OH)D concentrations (≥30 ng/mL).

CONCLUSION

Baseline 25(OH)D concentrations did not predict EVR or SVR. Because ritonavir impairs the conversion of 25(OH)D to the active metabolite, utilization of 25(OH)D may have been impaired in subjects taking ritonavir. This trial was registered at www.clinicaltrials.gov as NCT00078403.

摘要

背景

在丙型肝炎病毒（HCV）单感染患者中，25-羟维生素 D [25（OH）D]浓度与聚乙二醇干扰素/利巴韦林的反应呈正相关。关于 HIV 感染患者 25（OH）D 浓度与 HCV 治疗反应之间关系的数据有限。

目的

本研究旨在确定基线 25（OH）D 浓度是否可预测 HIV/HCV 合并感染患者的病毒学应答，并探讨与 25（OH）D 浓度≥30ng/mL 相关的变量。

设计

本回顾性研究对完成 HCV 治疗试验的 144 例 HCV 基因型 1、未经治疗的患者的数据和样本进行了检测。早期病毒学应答（EVR）定义为聚乙二醇干扰素/利巴韦林治疗第 12 周时 HCV RNA 降低≥2log10 和/或 HCV RNA<600IU/ml。通过液相色谱/串联质谱法测量基线 25（OH）D。

结果

与非 EVR 对照组（n=68）相比，EVR 组（n=76）更年轻，肝硬化患者更少，IL28B CC 基因型的比例更高，白蛋白浓度更高，基线 HCV 病毒载量更低（P≤0.05）。EVR 和非 EVR 患者之间的基线 25（OH）D 浓度差异无统计学意义（中位数：25ng/ml 比 20ng/ml；P=0.23）。持续病毒学应答（SVR）也有类似结果。多变量分析显示，白人和西班牙裔种族（OR：6.26；95%CI：2.47，15.88；P=0.0001）和利托那韦的使用（OR：2.68；95%CI：1.08，6.65；P=0.033）与更高的 25（OH）D 浓度（≥30ng/ml）相关。