AIM: To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
METHODS: Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
RESULTS: Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA 8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
CONCLUSION: We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
we do know low vit d levels are due to hbv and that normal levels correlates with low or no replication and now even hbsag clearance..................
now we do have to find out if making vit d levels normal by supplements will have similar impact of course over years and years since natural hbsag clearance is a slow process
may be in crn hep b who not able able to clear , their immune system work in wrong direction and interfers with production of vit d ,so low vit d in these people. those who clear their immune sys works in correct steps and dont interfere with vit d production. thing is to know whether vit d is cause or the effect of cronic? any informed memeber, biology person or stefeno can put light on this. as far as i know for my case hbsag before deficient 20nmol vit d was 125000 afer 45 days now with 100 nmol/ml vit d ,hbsag is 96000, does it indicate some thing? may interferon help? inbetween lympho count was 45 now in upper normal 40.
hbv releases nagalase, which inhibits immune response. your immune cells need to attach to vitamin d, but you can't get any because of nagalase. if you increase vitamin d, then some more of your immune cells can get to vitamin d to respond before nagalase attacks them. that's what i thought
here is one of stef's post on nagalase
this is his followup post
Extracts from the paper: [please note the association is not proven to be causal]
The mechanisms that link vitamin D normal levels with spontaneous HBsAg seroclearance are unknown. HBV infection has also been associated with a variety of immunological manifestations, including non-organ-specific autoantibodies, membranous and membranous proliferative glomerulonephritis, mixed cryoglobulinemia and polyarteritis nodosa[
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Destroy user interface control6]. Moreover, about one third of patients with polyarteritis nodosa are infected by HBV, the vasculitic lesions usually appear during primary HBV infection and are related to the presence of HBeAg. Anti-HBe seroconversion, either spontaneous or induced by a
. Another finding of our study was the importance of host and virological factors in spontaneous HBsAg seroclearance, similar to previously published data that indicate that older age, male gender, low viral load and HBeAg-seronegativity are associated with spontaneous HBsAg seroclearance. Our data supported these findings.
Our study contains some limitations. The link between vitamin D levels and HBsAg seroclearance was not shown to be causal but associative. The retrospective pattern of this study was unable to determine the cause effect of vitamin D levels to HBsAg seroclearance. More studies with a larger number of patients and with a prospective and controlled design are needed to confirm this hypothesis. Furthermore, this study did show that a very high percentage of spontaneous converters do have high levels of vitamin D but this percentage was not compared to a similar group of patients with hepatitis B without a spontaneous seroclearance. Other limitations are that the study had a small number of participants and did not exclude obese or overweight patients. These patients may have low levels of vitamin D. Patients with hepatic steatosis were also included in our study, although it is known that steatosis is an important predictor host factor for spontaneous HBsAg seroclearance.
for now we have only two points in favour of immune boost:
- peginterferon response is increased by vit d and vit d deficency is correlated to peginterferon non-response
- trl7 receptor activity is increased (trl7 is the receptors of immune cells that can detect infected cells)
activation of macrophages and immune cells in general is increased
so of course taking vit d increases immune response but of course this cannot mean by itself can generate a clearance of the virus but our experience and posts of forum members taking vit d can do as much as trials, especially results from forum members not on therapy reported year after year
only those hbeag negative better try. a member hbeag pos on pegintf plus tdf already got vit d about 115ng/ml, no effect and still no pegintf response
as to me i am taking too many things to say, my sister is not on therapy and she is taking highdose vit d, she has a very slow hbsag decline from about 20.000iu/ml, hbeag negative, hbvdna no effect for now
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