6533b857fe1ef96bd12b3c32

RESEARCH PRODUCT

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

subject

description

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 ⩾80% 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±9.8ng/ml, including 162 (85%) patients with level ⩽30ng/ml. Serum 25(OH)D3 levels were significantly correlated with the histological Metavir fibrosis score ( r =−0.16; 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±10.0 vs. 18.9±8.5 and 20.9±11.1ng/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 =−0.22; p =0.008) and serum α2-macroglobulin levels ( r =−0.23; 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.