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J Infect. 2014 Feb;68(2):176-84. doi: 10.1016/j.jinf.2013.10.011. Epub 2013 Nov 1.

Vitamin D deficiency is associated with severity of liver disease in HIV/HCV coinfected patients.

Author information

  • 1Unit of Viral Infection and Immunity, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
  • 2Infectious Diseases - HIV Unit, Hospital General Universitario "Gregorio Marañón", Madrid, Spain; Health Research Institute "Gregorio Marañón", Madrid, Spain.
  • 3Infectious Diseases - HIV Unit, Hospital General Universitario "Gregorio Marañón", Madrid, Spain.
  • 4Pathology Department, Hospital General Universitario "Gregorio Marañón", Madrid, Spain.
  • 5Unit of Viral Infection and Immunity, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Electronic address: sresino@isciii.es.

Abstract

OBJECTIVE:

To study the association of plasma 25-hydroxy vitamin D (25(OH)D) levels in HIV/HCV coinfected patients with severity of liver disease and virological response to hepatitis C virus (HCV) therapy with pegylated-interferon-alpha plus ribavirin (pegIFNα/RBV).

METHODS:

A cross-sectional study in 174 HIV/HCV coinfected patients that underwent a liver biopsy previously to start HCV therapy and a retrospective study of 125 of them. Plasma 25(OH)D levels were quantified by enzyme immunoassay. Liver biopsies were evaluated by METAVIR score. A sustained virological response (SVR) was defined as an undetectable serum HCV viral load (<10 IU/mL) up through 24 weeks after the end of HCV treatment.

RESULTS:

The median of plasma 25(OH)D level was 48 nmol/L (p25th: 32.5; p75th: 56.1) and 27 (15.5%) had 25(OH)D deficiency (<25 nmol/L). The percentage of 25(OH)D deficiency was higher in patients with significant fibrosis (F ≥ 2) (92.6% vs. 57.1%; p = 0.010) and moderate necroinflammatory activity grade (A ≥ 2) (85.2% vs. 60%; p = 0.043). However, adjusted logistic regression analyses showed that 25(OH)D deficiency was only associated with severity of liver disease [F ≥ 2 (OR = 8.47 (95% of confidence interval (CI) = 1.88; 38.3); p = 0.005) and A ≥ 2 (OR = 3.25 (95%CI = 1.06; 10.1); p = 0.040)]. Moreover, any significant relationship was found between 25(OH)D deficiency and SVR after HCV therapy.

CONCLUSION:

Plasma 25(OH)D deficiency was associated with liver disease severity in HIV/HCV coinfected patients, but it was not associated with HCV treatment failure.

Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:

AIDS; Antiviral therapy; Chronic hepatitis C; Hepatic biopsy; Liver fibrosis; Vitamin D

PMID:
24184809
[PubMed - in process]
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