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BMC Infect Dis. 2016 Sep 23;16(1):507.

Association of vitamin D deficiency with hepatitis B virus - related liver diseases.

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Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
Vietnamese-German Center for Medical Research (VG-CARE), Hanoi, Vietnam.
Department of Infectious Diseases, Duc Giang Hospital, Hanoi, Vietnam.
Department of Molecular Biology, 108 Military Central Hospital, Hanoi, Vietnam.
Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.
Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam.
Fondation Congolaise pour la Recherche Medicale, Brazzaville, Republic of Congo.
Vietnamese-German Center for Medical Research (VG-CARE), Hanoi, Vietnam.
Institute of Clinical Infectious Diseases, 108 Military Central Hospital, Tran Hung Dao Street N1, Hai Ba Trung District, Hanoi, Vietnam.



As an immune modulator, vitamin D is involved in various pathophysiological mechanisms in a plethora of diseases. This study aims to correlate the vitamin D deficiency status and clinical progression of liver diseases associated with hepatitis B virus (HBV) infection in patients in Vietnam and to compare it to healthy controls.


We quantified the levels of total vitamin D [25-(OH) D2 and D3] in serum samples from 400 HBV patients (chronic hepatitis B infection [CHB], n = 165; HBV-associated liver cirrhosis [LC], n = 127; HBV-associated hepatocellular carcinoma [HCC], n = 108) and 122 unrelated healthy controls (HC). Univariate and multivariate analyses were performed in order to determine the association between vitamin D levels and distinct clinical parameters.


The prevalence of vitamin D inadequacy (<30 ng/mL) was high among healthy individuals (81.7 %) as well as in HBV patients (84.3 %). Vitamin D deficiency (<20 ng/ml) or severe deficiency (<10 ng/ml) was observed more frequently among HBV patients (52 %) and subgroups (CHB, 47.8 %; LC, 54.4 %; HCC, 55.3 %) compared to the control group (32.5 %) (P < 0.001). Vitamin D levels and HBV-DNA load were strongly and inversely correlated (rho = -0.57, P < 0.0001). Multivariate regression analysis also revealed an independent association of HBV-DNA loads with low vitamin D levels (P = 0.0004). In addition, reduced vitamin D levels were associated with significant clinical progression of LC (Child-Pugh C versus Child-Pugh A, P = 0.0018; Child-Pugh C versus Child-Pugh B, P = 0.016).


Vitamin D deficiency was observed in the majority of HBV-infected patients and associated with adverse clinical outcomes. Our findings suggest that substitution of vitamin D may be a supportive option in the treatment of chronic liver diseases, in particular of HBV-associated disorders.


Chronic liver disease; HBV infection; Hepatocellular carcinoma; Liver cirrhosis; Vitamin D deficiency

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