July 09, 2014
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Low vitamin D increased risk for advanced liver fibrosis, decreased SVR rate among patients with HCV

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Risks for advanced liver fibrosis and odds for achieving sustained virologic response were affected by vitamin D levels in patients with hepatitis C virus who were taking pegylated interferon-alfa with ribavirin in a recent study.

Researchers conducted a meta-analysis of 14 included studies published from 2011 to 2014 after a literature search of PubMed, Scopus, Lilacs and Cochrane Library databases. Seven studies focused on vitamin D and advanced liver fibrosis (ALF) in treatment-naive patients with chronic hepatitis C virus (HCV; n=1,083), and 11 centered on vitamin D and its relationship with patients with chronic HCV who achieved sustained virologic response (SVR) with pegylated interferon-alfa plus ribavirin (n=2,672). Four studies were examined in both analyses.

Data indicated that almost 70% of all patients had 25-hydroxyvitamin D (25[OH]D) levels that were considered suboptimal (<20 ng/mL or <30 ng/mL), and almost 50% of the patients displayed deficient levels of 25(OH)D (<10 ng/mL or <20 ng/mL). Greater suboptimal levels of vitamin D were observed in 82.7% of patients coinfected with HCV and HIV vs. 66.2% among patients with HCV.

Vitamin D status was associated with ALF, including cut-offs of 10 ng/mL (OR=2.37; 95% CI, 1.20-4.72) and 30 ng/mL (OR=2.22; 95% CI, 1.24-3.97). In the SVR studies, pooled ORs showed an association between cut-offs of 20 ng/mL and SVR for patients when a specific HCV genotype was not stratified (OR=0.53; 95% CI, 0.31-0.91). Heterogeneity also was observed across the SVR studies (P<.001).

“This meta-analysis shows that a low vitamin D status in CHC patients is associated with a higher likelihood of having ALF and lower odds of achieving SVR, suggesting the utility of vitamin D screening in HCV-infected patients,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.