Eltayeb Azza A, Abdou Madleen Adel A, Abdel-aal Amal M, Othman Mostafa H
Azza A Eltayeb, Children University Hospital, Assiut University, 71515 Assiut, Egypt.
World J Gastroenterol. 2015 Jan 28;21(4):1284-91. doi: 10.3748/wjg.v21.i4.1284.
To study the frequency of vitamin D deficiency in patients with hepatitis C virus (HCV) infection and to evaluate the role of vitamin D supplementation in improving antiviral therapy.
Sixty-six children aged from 7-14 years (mean ± SD, 11.17±2.293) diagnosed with HCV infection were matched to 28 healthy controls. Serum levels of 25 (OH) D3, calcium, phosphorus, alkaline phosphatase and plasma level of parathormone were measured. Quantitative PCR for HCV was performed Bone density was determined by dual energy X-ray absorptiometry. All cases received conventional therapy, and only 33 patients received vitamin D supplementation.
Children with HCV showed significantly increased levels of HCV RNA (P<0.001), parathormone (P<0.01) and decreased vitamin D levels (P<0.05) (33.3% deficient and 43.3% insufficient) compared with controls. Abnormal bone status (Z score -1.98±0.75) was found in ribs, L-spine, pelvis and total body. Cases treated with vitamin D showed significant higher early (P<0.04) and sustained (P<0.05) virological response. There was a high frequency of vitamin D deficiency among the Egyptian HCV children, with significant decrease in bone density. The vitamin D level should be assessed before the start of antiviral treatment with the correction of any detected deficiency.
Adding vitamin D to conventional Peg/RBV therapy significantly improved the virological response and helped to prevent the risk of emerging bone fragility.
研究丙型肝炎病毒（HCV）感染患者维生素D缺乏的发生率，并评估补充维生素D在改善抗病毒治疗中的作用。
将66例年龄在7至14岁（平均±标准差，11.17±2.293）被诊断为HCV感染的儿童与28名健康对照进行匹配。检测血清25（OH）D3、钙、磷、碱性磷酸酶水平以及血浆甲状旁腺激素水平。进行HCV定量PCR检测。采用双能X线吸收法测定骨密度。所有病例均接受常规治疗，仅33例患者接受维生素D补充治疗。
与对照组相比，HCV感染儿童的HCV RNA水平（P<0.001）、甲状旁腺激素水平显著升高（P<0.01），维生素D水平降低（P<0.05）（33.3%缺乏，43.3%不足）。在肋骨、腰椎、骨盆和全身发现骨状态异常（Z值为-1.98±0.75）。接受维生素D治疗的病例早期（P<0.04）和持续（P<0.05）病毒学应答显著更高。埃及HCV感染儿童中维生素D缺乏发生率较高，骨密度显著降低。在开始抗病毒治疗前应评估维生素D水平，并纠正任何检测到的缺乏情况。
在常规聚乙二醇干扰素/利巴韦林（Peg/RBV）治疗中添加维生素D可显著改善病毒学应答，并有助于预防出现骨脆性的风险。
