Low 25-OH vitamin D serum levels correlate with severe fibrosis in HIV-HCV co-infected patients with chronic hepatitis

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• 作者：Benjamin Terrier¹ ; ² ; Fabrice Carrat³ ; Guillaume Geri¹ ; ² ; Stanislas Pol⁴ ; Lionel Piroth⁵ ; Philippe Halfon⁶ ; Thierry Poynard⁷ ; Jean-Claude Souberbielle⁸ ; Patrice Cacoub¹ ; ² ; ^{patrice.cacoub@psl.aphp.fr}
• 关键词：Hepatitis C virus ; Human immunodeficiency virus ; Chronic hepatitis ; 25-OH vitamin D ; Severe fibrosis
• 刊名：Journal of Hepatology
• 出版年：2011
• 出版时间：October, 2011
• 年：2011
• 卷：55
• 期：4
• 页码：756-761
• 全文大小：1K

文摘

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Background & Aims

Recent findings in hepatitis C virus (HCV)-monoinfected patients have shown a correlation between low serum levels of 25-OH vitamin D3 [25(OH)D3] and severe liver fibrosis and low sustained virologic response to therapy. Data are lacking in HIV-HCV coinfected patients.

Methods

One hundred and eighty nine HIV-HCV coinfected patients, who received ?0 % of interferon (IFN) plus ribavirin therapy, were analyzed for baseline serum 25(OH)D3 levels. Correlations between serum 25(OH)D3 levels, chronic hepatitis C features, HCV virologic response to antiviral therapy, and HIV infection characteristics were analyzed.

Results

Mean serum 25(OH)D3 level was 18.5 ¡À 9.8 ng/ml, including 162 (85 % ) patients with level ?0 ng/ml. Serum 25(OH)D3 levels were significantly correlated with the histological Metavir fibrosis score (r = ?.16; p = 0.027). Patients with severe fibrosis (Metavir F3/F4) had lower serum 25(OH)D3 levels compared to F2 and F1 patients (16.2 ¡À 10.0 vs. 18.9 ¡À 8.5 and 20.9 ¡À 11.1 ng/ml, respectively; p = 0.06). In multivariate analysis, low serum 25(OH)D levels were independently associated with severe liver fibrosis (p = 0.04) and cold season (p = 0.0002). Serum levels of 25(OH)D3 were also significantly correlated with liver fibrosis as assessed by FibroTest? (r = ?.22; p = 0.008) and serum ¦Á2-macroglobulin levels (r = ?.23; p = 0.006). In contrast, no correlation was found between 25(OH)D3 levels and HCV sustained virologic response to IFN-based therapy [OR 0.98 (0.95-1.01); p = 0.22]. No association was found between 25(OH)D3 levels and markers of HIV-related immunodeficiency.

Conclusions

In HIV-HCV coinfected patients, low serum 25(OH)D3 levels correlate with severe liver fibrosis. In contrast, serum 25(OH)D3 levels are not linked to HCV virologic response to therapy or severity of immunodeficiency.