Melo-Villar Livia, Lampe Elisabeth, de Almeida Adilson J, de P Scalioni Letícia, Lewis-Ximenez Lia L, Miguel Juliana C, Del Campo José A, Ranchal Isidora, Villela-Nogueira Cristiane A, Romero-Gomez Manuel
Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
Unit for the Clinical Management of Digestive Diseases and CIBERehd, Hospital Universitario de Valme, Sevilla, Spain.
Ann Hepatol. 2015 Jul-Aug;14(4):457-63.
The relationship between 25-hydroxyvitamin D [25(OH)D] serum levels and response to antiviral therapy and laboratory data in HCV infection remains unclear. The aim of this study was to determine pre-treatment 25(OH)D serum level among HCV infected individuals and to evaluate the association between vitamin D status, virological response, and laboratory data.
Baseline serum 25(OH)D levels were measured in 237 chronic HCV infected patients (139 female, age 53.7 ± 11.2 years) using chemiluminescence immunoassay. Correlations between serum 25(OH)D levels, virological and laboratory data regarding HCV infection as well as sustained virological response (SVR) to antiviral therapy were evaluated.
Mean serum values of 25(OH)D was 26.2 ± 12 ng/mL and prevalence of vitamin D deficiency (< 30 ng/mL) was 66.2%. Advanced age (> 55 years), high mean values of LDL, total cholesterol, HDL and low mean values of alkaline phosphatase and hemoglobin were statistically associated to vitamin D deficiency. Antiviral treatment was underwent by 133 HCV patients and 44.3% of them achieved SVR. Most of individuals that presented SVR also presented 25(OH)D level higher than 30ng/mL (55.9%). SVR was associated to low mean values of LDL, total cholesterol and platelets; high mean values of ALT, AST and low fibrosis grade.
In conclusion, low vitamin D levels were observed among HCV infected patients and was associated to laboratory findings, however baseline 25(OH)D level is not independently associated with SVR.
25-羟基维生素D[25(OH)D]血清水平与丙型肝炎病毒(HCV)感染患者抗病毒治疗反应及实验室数据之间的关系仍不明确。本研究旨在确定HCV感染个体治疗前的25(OH)D血清水平,并评估维生素D状态、病毒学反应和实验室数据之间的关联。
采用化学发光免疫分析法测定237例慢性HCV感染患者(139例女性,年龄53.7±11.2岁)的基线血清25(OH)D水平。评估血清25(OH)D水平、HCV感染的病毒学和实验室数据以及抗病毒治疗的持续病毒学应答(SVR)之间的相关性。
25(OH)D的平均血清值为26.2±12 ng/mL,维生素D缺乏(<30 ng/mL)的患病率为66.2%。高龄(>55岁)、低密度脂蛋白、总胆固醇、高密度脂蛋白的平均高值以及碱性磷酸酶和血红蛋白的平均低值与维生素D缺乏在统计学上相关。133例HCV患者接受了抗病毒治疗,其中44.3%实现了SVR。大多数实现SVR的个体其25(OH)D水平也高于30 ng/mL(55.9%)。SVR与低密度脂蛋白、总胆固醇和血小板的平均低值相关;与谷丙转氨酶、谷草转氨酶的平均高值和低纤维化分级相关。
总之,HCV感染患者中观察到维生素D水平较低,且与实验室检查结果相关,然而基线25(OH)D水平与SVR无独立相关性。