Belle Arthur, Gizard Emmanuel, Conroy Guillaume, Lopez Anthony, Bouvier-Alias Magali, Rouanet Stéphanie, Peyrin-Biroulet Laurent, Pawlotsky Jean-Michel, Bronowicki Jean-Pierre
Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France.
National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Créteil, France.
United European Gastroenterol J. 2017 Feb;5(1):69-75. doi: 10.1177/2050640616640157. Epub 2016 Jul 7.
The impact of 25-OH vitamin D on sustained viral response (SVR) to antiviral therapy and on fibrosis progression in hepatitis C is debated. We assessed the impact of 25-OH vitamin D concentration on the efficacy of antiviral therapy in naïve genotype 1 hepatitis C virus (HCV)-infected patients.
The study population consisted of treatment-naïve genotype 1 patients enrolled in a randomised controlled trial. A total of 516 patients received peginterferon α-2a 180 µg/week plus ribavirin 800 mg/day for 24 weeks. There were 349 patients with undetectable HCV RNA (<50 IU/ml) at week 24 (W24) who were randomised to continue dual therapy ( = 173) or to continue peginterferon alone ( = 176) until week 48. 25-OH vitamin D concentration was measured at baseline in frozen serum.
A total of 461 patients could be analysed for virologic response at W24, and 285 (119 non-responders at W24 + 166 responders who continued dual therapy until W48) for the impact of SVR. There were 487 patients who could be analysed for fibrosis progression. Metavir fibrosis scores (centralised analysis) were: F1 30%, F2 34%, F3 27% and F4 9%. Median 25-OH vitamin D concentrations were similar in virologic responders (13.5 ng/ml) and in non-responders at W24 (12.6 ng/ml), as well as in patients with SVR (12.8 ng/ml) and without SVR (12.8 ng/ml, 3.99) at W72. Median 25-OH vitamin D concentrations were: F1: 14.30 ng/ml, F2: 13.50 ng/ml, F3: 13.30 ng/ml and F4: 12.80 ng/ml.
In this study, 25-OH vitamin D level has no impact on the efficacy of antiviral therapy in naïve genotype 1 HCV-infected patients.
25-羟基维生素D对丙型肝炎抗病毒治疗的持续病毒学应答（SVR）及纤维化进展的影响存在争议。我们评估了25-羟基维生素D浓度对初治基因1型丙型肝炎病毒（HCV）感染患者抗病毒治疗疗效的影响。
研究人群包括参加一项随机对照试验的初治基因1型患者。共有516例患者接受每周180μg聚乙二醇干扰素α-2a加每日800mg利巴韦林治疗24周。24周（W24）时丙型肝炎病毒核糖核酸（HCV RNA）检测不到（<50IU/ml）的349例患者被随机分为继续联合治疗组（n = 173）或继续单独使用聚乙二醇干扰素组（n = 176）直至48周。在基线时检测冻存血清中的25-羟基维生素D浓度。
共有461例患者可分析W24时的病毒学应答情况，285例（W24时119例无应答者 + 166例继续联合治疗至W48的应答者）可分析SVR的影响。共有487例患者可分析纤维化进展情况。Metavir纤维化评分（集中分析）为：F1占30%，F2占34%，F3占27%，F4占9%。病毒学应答者（13.5ng/ml）与W24时无应答者（12.6ng/ml）以及W72时获得SVR的患者（12.8ng/ml）与未获得SVR的患者（12.8ng/ml，P = 3.99）的25-羟基维生素D浓度中位数相似。25-羟基维生素D浓度中位数为：F1：14.30ng/ml，F2：13.50ng/ml，F3：13.30ng/ml，F4：12.80ng/ml。
在本研究中，25-羟基维生素D水平对初治基因1型HCV感染患者的抗病毒治疗疗效无影响。
