Author/Authors :
Vosoghinia، Hasan نويسنده Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran , , Esmaeilzadeh، Abbas نويسنده Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran , , Ganji، Azita نويسنده , , Hosseini، Seyed Mousal Reza نويسنده Department of Gastrology, Ghaem Hospital, Mashhad, Iran. Hosseini, Seyed Mousal Reza , Jamehdar، Saeid Amel نويسنده Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran , , Salehi، Maryam نويسنده Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Salehi, Maryam , Bahari، Ali نويسنده Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran , , Ghanaei، Omid نويسنده Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran , , Sahebari، Maryam نويسنده Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran , , Rajabzadeh، Farnood نويسنده Department of Radiology, School of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, IR Iran , , Ghaffarzadehgan، Kamran نويسنده Research and Education Department, Razavi Hospital, Mashhad, Iran , , Goshayeshi، Ladan نويسنده Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran ,
Abstract :
Patients chronically infected with the hepatitis C virus (HCV) are more likely to have vitamin D deficiency Recent studies revealed that vitamin D has immunomodulator and antiviral properties and can enhance the effect of interferon on the HCV virus. We aimed to assess the influence of vitamin D supplementation on viral response to PegINF/RBV therapy. In a randomized-controlled trial 66 patients with HCV (30 with genotype 1or 4 and 36 with genotype 2 or 3) were randomly divided into two groups in gastroenterology clinic: the study group (n = 34) received oral vitamin D supplementation (1600 IU/day) to maintain serum levels > 30 ng/mL besides the routine treatment of 180 μg PegINF-α2a plus oral ribavirin. The control group (n = 32) received the same treatment without vitamin D supplementation. The primary outcome was undetectable HCV-RNA at week 12 of treatment, referred to as complete early viral response (cEVR). Real-time polymerase chain reaction (sensitivity: 10 IU/mL) was used to assess HCV RNA. Serum Vitamin D levels were measured at baseline and weeks 4, 8, 12 and 24 of treatment. Spearman’s correlation showed that baseline vitamin D correlated with the stage of liver fibrosis in both study and control group (P = 0.04, r = 0.57). There were no significant differences in baseline characteristics between two groups except serum AST level. Complete EVR rate at week 12 in the vitamin D group was significantly higher than the controls (100% vs 84.4%; P = 0.023) whereas this figure was not significant when genotypes 1 and 4 or 2 and 3 in the test group were compared to those of the control (100% vs 86.7%; P = 0.19 and 100% vs 82.4%; P = 0.22). Serum vitamin D levels were lowest at baseline (22 ± 15 ng/mL), but increased after 12 weeks of vitamin D therapy to a mean level of 52 ± 38 ng/mL (P = 0.02) in study group. The addition of vitamin D to conventional PegIFN/RBV therapy in HCV patients may significantly improve the viral response.
