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Normal vit D levels are associated with hbsag seroclearance.

Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance.
Mahamid M, Nseir W, Abu Elhija O, Shteingart S, Mahamid A, Smamra M, Koslowsky B.
Source
Mahmud Mahamid, Shimon Shteingart, Mosab Smamra, Benjamin Koslowsky, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem 93722, Israel.
Abstract
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.
499 Responses
Avatar universal
that s good i think we hve to try to make it very high like 100ng/ml and see what happens, i guess the response might be very very slow like for my sister when hbsag is high and faster when hbsag is 1000-1500iu/ml

our experience here might build a good evidence if many participate
Avatar universal
all this study is suggesting is that those who seroconvert to HBsAg negative happen to have a normal Vit D level.  Maybe the loss of surface antigen means that the individual is able to retain vitamin D better?  This does not suggest that having a normal vitamin D level will induce surface antigen loss by any means, so don't get your hopes up.
Avatar universal
You are right I could well be a cosequence rather than the cause.

It is like for instance if alot of cars that finished the race were dirty does not mean that making your car dirty at the start can help it finish the race...

The was a study that found out that the concentration of  7-Dehydrocholesterol (precoursor of vit D) in hbv infected hepatocytes is abnormally high.

It could well be that infected hepatocytes attract 7-DHC from the blood to the liver and less of it is left in the blood to produce Vit D from the sun. So HBVers just can not make enough of vit D from the sun. Therefore the more infected hepatocytes one has the less vit d is in the body. So hbsag and vit d3 levels are negatevely correlated. This is just my hypotesys ....

But it does not mean that we should not supplement vit d3. It may be useles for the virus but fixes vit d defficiency that is beneficial for immune system.

Avatar universal
increasing vit d is always beneficial because pegintf fails with low vit d and doubles response with high vit d and also trl7 receptor is increased too, so we cannot prove hbsag clearance but we have proof vit d must be optimum range for things to work
Avatar universal
what is the recommended preventive dosage for vit D? is  5000 IU every two weeks suitable??

  my last vit D level  was 60.
Avatar universal
it is not a matter of dose, anyone responds different due to the level of hbv infection, so the point is reach and mantain optimum levels.

drug makers made disinformation and confusion by the use of different units and different machines reporting wrong ranges.the official unti is ng/ml and normal range 50-100ng/ml, possible toxicity over 150ng/ml which can be prevented by vit k2 300-400mcg daily

best target range for now is around 90ng/ml, if you were 60ng/ml you may reach 90ng/ml by 5000iu daily
Avatar universal
this vit d issue must be studied thoroughly, cause or effect , but surely there is much in this. though i am favour of taking vit d .
Avatar universal
Stefan. I take 15000 iu daily and I have only reached 50 ng/ml

I had very low vit d levels. I had 12 ng about  a year ago. That is why I had all those terrible chest pains if a little tired or had less sleep. Of course the doctors on this side of the pond that charge $400-500 for a visit had no answers for me.; yep.
Avatar universal
I was taking 10000iU daily withing a month and my vit d went up from 30 till 60.

Do you know your hbsag quantity?
Avatar universal
This test is not available here!
Avatar universal
i was 89ng/ml in june so tried to lower from 10.000iu daily to 5000iu daily and lost 20points to 72ng/ml, so there is so much interference from hbv on vit d, definitely nothing to do with healthy people at all, vit d acts like a water soluble vitamin on some of us with no accumulation at all

so the only way to reach around 90ng/ml for me is stay on 10.000-15.000iu daily at least, i suggest you try the same with k2 combo 400mcg, puritans has affordable k2 and even a brand with d3 plus k2 sublingual pills but only 1000iu per pill
Avatar universal
I was taking 10000 IU vit D3 and added 100iu of K2. When I added K2 phosphorus and Calcium decreased back to normal values, so maybe 400 iU is not necessary.

As mentioned above I gained 20 ng/ml of vit D in a month ( before I was taking 5000 iu and it has no effect) but I also was playing an hour of tennis at 11:00 every day without T-short within this month.

Now I decreased d3 to 5000 iu will see if it holds the level...
Avatar universal
i tried breaking 60.000iu pack in two parts and taking them at 3 day apart, means 10.000 iu/day. no sides or anything feeling better, though my initial level was in deficient category around 20 nmol/ml. now in normal range around 150 nmol/ml in one month. it proves stef's  theory that in hep b cases vit d acts as water solube vit.
Avatar universal
attention to units i was using 400mcg daily, not iu, since a researcher on this suggested that dose to keep calcium out of blood and fixed to the bones, she said such amount will prevent any possible accumulation in blood vessels, she said it is best to keep this high amount because k2 has no toxicity and because accumulation in vessels may happen even with normal vit d and normal calcium

as to how to change k2 in iu to mcg i dont know most makers report k2 in mcg
Avatar universal
Sorry I mean mcg, not the units it is a misprint....
Avatar universal
By the way DNA went under from 70 iu,

Alt went up from 53 to 69.

Do not know if it is related to vit D increase...
Avatar universal
here are my sisters tests, she is not on any treatment just vit d3 from 5000 to 10.000iu daily and some other B vitamins, fish oil

15 06 2010   hbsag   17379iu/ml vitd25oh 11ng/ml
28 09 2011   hbsag   18183iu/ml vitd25oh 66ng/ml
15 02 2012   hbsag   17476iu/ml vitd25oh 69ng/ml
20 04 2012    hbsag  20790iu/ml vitd25oh 68ng/ml
24 01 2013    hbsag  13783iu/ml vitd25oh 76ng/ml
10 07 2013    hbsag  12906iu/ml vitd25oh 67ng/ml

she had hbsag decrease on alinia too at about 13.000iu/ml but after 3-6 months on it it relapsed to 17.000iu/ml so i did not report the alinia period here
Avatar universal
she is planning to go on vitd3 15000iu daily and vit k2 400mcg daily and see if the hbsag decline stays like this or fasten, it is also important to menthion that her hbvdna is always detactable so hbsag lowering is more difficult on her

hbvdna
2010 around 300.000iu/ml
2011 around   88.000iu/ml
2012 around   43.220iu/ml
2013 we lost the test result, if we find it we ll post it or retest soon
Avatar universal
i mean she will take more d3 to target 90-100ng/ml of blood vitd25oh
Avatar universal
Just got my hbsag =

2/04 1800 UI/ml, vit d 29 ng/ml
2/06 1760 ui/ml, vit d 31 ng/ml
8/07 1590 UI/ml, vit d 59 ng/ml

Small decreace within a month I hope it is a trend,
Avatar universal
With these numbers you need to go on interferon. And maybe in 6 months you will be a new man.
Avatar universal
I will try taking  25000 units daily. And increase vitamin k2.

I am not able to clime past 50ng on 10-15000 iu of vitamin d3.
Avatar universal
The DNA went below 20 iu from 70 a month ago and ALT went up from 50 to 70.
Optimistically it can be interpreted as follows:

When VL is getting down reinfection decreases also
ALT up means the immune system kills more infected cells.  All this decreases the quantity of infected cells, and therefore decrease  hbsag production.

The problem is as the number of infected cells goes down the immune response goes down too, so it should come to another balance point but not clear completely.
Avatar universal
http://www.healio.com/hepatology/chronic-hepatitis/news/online/%7B8f54ef2a-1341-40e6-84d1-de714b2effff%7D/antiretroviral-therapy-decreases-25-oh-vitamin-d-levels-in-hivhbv-coinfected-patients

Antiretroviral therapy decreases 25-OH vitamin D levels in HIV/HBV coinfected patients

this is on hiv coinfected too so it may not have the same results on hbv but anyway it is best to supplement d3 for us hbvers and use high dose d3 if the blood levels stay low both off therapy or on nucs therapy
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