Hepatology. 2013 May 22. doi: 10.1002/hep.26488. [Epub ahead of print]
Low vitamin D serum concentration is associated with high levels of hepatitis B virus (HBV) replication in chronically infected patients.
Farnik H, Bojunga J, Berger A, Allwinn R, Waidmann O, Kronenberger B, Keppler OT, Zeuzem S, Sarrazin C, Lange CM.
Source
Medizinische Klinik 1, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, Haus 11, 60590 Frankfurt, Germany.
Abstract
Vitamin D is an important immune modulator which plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). In contrast, the relationship between vitamin D metabolism and chronic hepatitis B is less well characterized. Therefore, we quantified 25-hydroxyvitamin D [25(OH)D3 ] serum levels in a cohort of 203 treatment-naïve patients with chronic hepatitis B virus (HBV) infection and tested for their association with clinical parameters of chronic hepatitis B. 69 (34%), 95 (47%), and 39 (19%) out of 203 patients had severe vitamin D deficiency [25(OH)D3 <10ng/mL], vitamin D insufficiency [25(OH)D3 ≥10ng/mL and <20ng/mL], or adequate vitamin D serum levels [25(OH)D3 ≥20ng/mL], respectively. In both uni- and multivariate analyses, HBV DNA viral load (log10 IU/mL) was a strong predictor of low 25(OH)D3 serum levels (p=0.0007 and p=0.000048, respectively), and vice versa. Mean 25(OH)D3 serum concentrations in patients with HBV DNA <2000 IU/mL vs. ≥2000 IU/mL were 17 vs. 11 ng/mL, respectively (p<0.00001). In addition, hepatitis B early antigen (HBeAg) positive patients had lower 25(OH)D3 serum levels than HBeAg negative patients (p=0.0013). Finally, 25(OH)D3 and HBV DNA serum levels showed inverse seasonal fluctuations. Conclusions: Low 25(OH)D3 serum levels are associated with high levels of HBV replication in patients with chronic hepatitis B. This represents a major difference to chronic hepatitis C, were numerous previous studies have shown a lacking correlation between HCV viral load vitamin D serum levels. Inverse seasonal fluctuations of 25(OH)D3 and HBV DNA serum levels are suggestive for a functional relationship between both variables. (HEPATOLOGY 2013.).
Copyright © 2013 American Association for the Study of Liver Diseases.