Advertisement

Relationship of vitamin D status with advanced liver fibrosis and response to hepatitis C virus therapy: A meta-analysis

Authors

  • Mónica García-Álvarez,

    1. Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
    Search for more papers by this author
    • These authors contributed equally to this work.

  • Daniel Pineda-Tenor,

    Corresponding author
    1. Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
    • Address reprint requests to: Salvador Resino, Ph.D., or Daniel Pineda-Tenor, Ph.D., Centro Nacional de Microbiología, Instituto de Salud Carlos III (Campus Majadahonda), Carretera Majadahonda-Pozuelo, Km 2.2, 28220 Majadahonda, Madrid, Spain. E-mail: sresino@isciii.es or dpineda@isciii.es; fax: +34 918 223 269.

    Search for more papers by this author
    • These authors contributed equally to this work.

  • María A. Jiménez-Sousa,

    1. Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
    Search for more papers by this author
  • Amanda Fernández-Rodríguez,

    1. Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
    Search for more papers by this author
  • María Guzmán-Fulgencio,

    1. Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
    Search for more papers by this author
  • Salvador Resino

    Corresponding author
    1. Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
    • Address reprint requests to: Salvador Resino, Ph.D., or Daniel Pineda-Tenor, Ph.D., Centro Nacional de Microbiología, Instituto de Salud Carlos III (Campus Majadahonda), Carretera Majadahonda-Pozuelo, Km 2.2, 28220 Majadahonda, Madrid, Spain. E-mail: sresino@isciii.es or dpineda@isciii.es; fax: +34 918 223 269.

    Search for more papers by this author

  • 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.

Abstract

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)

Ancillary