We read with interest the article by Farnik et al. regarding the low vitamin D levels in patients with chronic hepatitis B virus (HBV). A remarkable finding was the inverse relationship between serum vitamin D levels and HBV viral load.
A previous study in patients with chronic hepatitis C had also shown that necroinflammatory activity as well fibrosis scores were independently linked to low vitamin D levels. Because of small cohort size, the researchers could not show an association between serum vitamin D levels and fibrosis scores. However, considering that necroinflammatory activity was not included in statistical analysis in this study; we would like to point out that high necroinflammatory activity may also explain the low vitamin D levels in patients with HBV. Before drawing a definitive conclusion, more details ought to be presented about this important issue.
Cumali Efe, M.D.1
Tugrul Purnak, M.D.1
Ersan Ozaslan, M.D.2
1Department of Gastroenterology Hacettepe University Ankara, Turkey
2Department of Gastroenterology Numune Research and Education Hospital Ankara, Turkey