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.

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.