These authors contributed equally to this work.
Relationship of vitamin D status with advanced liver fibrosis and response to hepatitis C virus therapy: A meta-analysis
Article first published online: 29 SEP 2014
© 2014 by the American Association for the Study of Liver Diseases
Volume 60, Issue 5, pages 1541–1550, November 2014
How to Cite
García-Álvarez, M., Pineda-Tenor, D., Jiménez-Sousa, M. A., Fernández-Rodríguez, A., Guzmán-Fulgencio, M. and Resino, S. (2014), Relationship of vitamin D status with advanced liver fibrosis and response to hepatitis C virus therapy: A meta-analysis. Hepatology, 60: 1541–1550. doi: 10.1002/hep.27281
Potential conflict of interest: Nothing to report.
Supported by grants from Fondo de Investigación de Sanidad en España (FIS) [Spanish Health Founds for Research], grant number PI11/00245; and Red Española de Investigación en SIDA (RIS) [AIDS Research Network] grant number RD12/0017/0024; D.P.T., M.G.F., M.A.J.S., and M.G.A. are supported by “Instituto de Salud Carlos III,” grant numbers CM12/00043, RD12/0017/0024, CD13/0001 and CD12/00442, respectively.
- Issue published online: 23 OCT 2014
- Article first published online: 29 SEP 2014
- Accepted manuscript online: 27 JUN 2014 03:31AM EST
- Manuscript Accepted: 21 JUN 2014
- Manuscript Received: 11 APR 2014
There is growing evidence that vitamin D is related to chronic hepatitis C (CHC) pathogenicity. We analyzed the relationship of vitamin D status with advanced liver fibrosis (ALF) in CHC treatment-naïve patients and sustained virologic response (SVR) in CHC patients on pegylated interferon alpha plus ribavirin (pegIFNα/ribavirin) therapy. We performed a meta-analysis of all eligible studies published to date (April, 2014) in PubMed, SCOPUS, LILACS, and the Cochrane Library, assessing plasma/serum vitamin D levels related to ALF and/or SVR. Pooled odds ratios (ORs) were estimated by either fixed or random effects models. Fourteen studies were selected from the literature search, seven for ALF (1,083 patients) and 11 for SVR (2,672 patients). For liver fibrosis, low vitamin D status was related to a diagnosis of ALF, with the cutoffs of 10 ng/mL (OR = 2.37, 95% confidence interval [CI] = 1.20, 4.72) and 30 ng/mL (OR = 2.22, 95% CI = 1.24, 3.97) being significant, and a near-significance for 20 ng/mL (OR = 1.44, 95% CI = 0.99, 2.12). Regarding SVR, a significant heterogeneity among studies was found (P < 0.001), and we only found a significant association with SVR for a vitamin D cutoff of 20 ng/mL (OR = 0.53, 95% CI = 0.31, 0.91). When meta-analysis was performed excluding the outliers, significant pooled ORs were found for all patients (10 ng/mL [OR = 0.48, 95% CI = 0.34, 0.67] and 20 ng/mL [OR = 0.58, 95% CI = 0.45, 0.76]) and GT1/4 patients (10 ng/mL [OR = 0.53, 95% CI = 0.34, 0.81] and 20 ng/mL [OR = 0.54, 95% CI = 0.39, 0.74]). Conclusion: Low vitamin D status in CHC patients is associated with a higher likelihood of having ALF and lower odds of achieving SVR following pegIFNα/ribavirin therapy. (Hepatology 2014;60:1541–1550)