Serum 25-hydroxyvitamin D3 levels affect treatment outcome in pegylated interferon/ribavirin combination therapy for compensated cirrhotic patients with hepatitis C virus genotype 1b and high viral load

被引：10

作者：

Atsukawa, Masanori ^{[1
]}

Tsubota, Akihito ^{[2
]}

Shimada, Noritomo ^{[3
]}

Kondo, Chisa ^{[1
]}

Itokawa, Norio ^{[1
]}

Nakagawa, Ai ^{[1
]}

Hashimoto, Satomi ^{[4
]}

Fukuda, Takeshi ^{[4
]}

Matsushita, Yoko ^{[4
]}

Narahara, Yoshiyuki ^{[4
]}

Iwakiri, Katsuhiko ^{[1
]}

Nakatsuka, Katsuhisa ^{[4
]}

Kawamoto, Chiaki ^{[4
]}

Sakamoto, Choitsu ^{[4
]}

机构：

[1] Chiba Hokusoh Hosp, Nippon Med Sch, Dept Internal Med, Div Gastroenterol, Inzai, Japan

[2] Jikei Univ, Sch Med, ICMR, Kashiwa, Chiba, Japan

[3] Shinmatsudo Cent Gen Hosp, Div Gastroenterol & Hepatol, Matsudo, Chiba, Japan

[4] Nippon Med Sch, Dept Internal Med, Div Gastroenterol & Hepatol, Tokyo 113, Japan

来源：

HEPATOLOGY RESEARCH | 2014年 / 44卷 / 13期

关键词：

cirrhosis; hepatitis C virus; 25-hydroxyvitamin D-3; pegylated interferon; ribavirin; sustained virological response; SUSTAINED VIROLOGICAL RESPONSE; COMMON GENETIC-DETERMINANTS; GENOME-WIDE ASSOCIATION; VITAMIN-D; HEPATOCELLULAR-CARCINOMA; PLUS RIBAVIRIN; PEGINTERFERON ALPHA-2B; NATURAL-HISTORY; SEVERE FIBROSIS; PEG-INTERFERON;

D O I：

10.1111/hepr.12298

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

AimMuch is unknown about the effect of 25-hydroxyvitamin D-3 levels on the outcome of pegylated interferon/ribavirin (PEG IFN/RBV) therapy for hepatitis C virus-related cirrhosis. The purpose of the present study was to analyze and elucidate factors, including 25-hydroxyvitamin D-3, that contribute to a sustained virological response (SVR) in patients with cirrhosis. MethodsWe analyzed whether 25-hydroxyvitamin D-3 contributes to the response to PEG IFN/RBV therapy among 134 cirrhotic patients. ResultsSVR was achieved in 43 patients. The median 25-hydroxyvitamin D-3 level was 20ng/mL. Univariate analysis showed that the following factors contributed to SVR: low-density lipoprotein cholesterol, albumin, 25-hydroxyvitamin D-3, core a.a.70 (a.a.70) substitutions, the number of mutations at the interferon sensitivity-determining region and IL28B genotype. Multivariate analysis identified IL28B genotype and 25-hydroxyvitamin D-3 as independent factors contributing to SVR. Subsequently, SVR rate was examined by using 25-hydroxyvitamin D-3 and other important factors. The SVR rate was 51.8% in patients with core a.a.70 wild and 15ng/mL of 25-hydroxyvitamin D-3, whereas the SVR rate was 7.1% in patients with core a.a.70 wild and <15ng/mL of 25-hydroxyvitamin D-3. The SVR rate was 56.9% in patients with IL28B major genotype and 15ng/mL of 25-hydroxyvitamin D-3. Surprisingly, the SVR rate was 0% in patients with IL28B minor genotype and <15ng/mL of 25-hydroxyvitamin D-3. ConclusionIL28B genotype and 25-hydroxyvitamin D-3 were identified as independent factors contributing to SVR. Stratified analyses according to core a.a.70 substitution and IL28B genotype suggested that 25-hydroxyvitamin D-3 influences the outcome of PEG IFN/RBV therapy for cirrhosis.

引用

页码：1277 / 1285

页数：9

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