Review article: the extra-skeletal effects of vitamin D in chronic hepatitis C infection

Authors

  • E. Cholongitas,

    1. 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
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  • E. Theocharidou,

    1. The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery, Royal Free Hospital, London, UK
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  • J. Goulis,

    1. 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
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  • E. Tsochatzis,

    1. The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery, Royal Free Hospital, London, UK
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  • E. Akriviadis,

    1. 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
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  • A. K. Burroughs

    Corresponding author
    1. The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery, Royal Free Hospital, London, UK
    • 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
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  • This uncommissioned review article was subject to full peer-review.

Correspondence to:

Prof. A. K. Burroughs, Liver Transplantation and Hepatobililary Medicine, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK.

E-mail: andrew.burroughs@nhs.net

Summary

Background

Recent interest has focused on the extra-skeletal effects of vitamin D, in particular, in patients with chronic hepatitis C.

Aims

To review data in the literature regarding the extra-skeletal effects of vitamin D in patients with chronic hepatitis C, with and without liver transplantation.

Methods

A Medline search was performed for relevant studies up to August 2011 using the terms ‘vitamin D’ ‘chronic liver disease’ and ‘hepatitis C’.

Results

Vitamin D deficiency is very frequent before liver transplantation ranging between 51% and 92%, whereas, in the liver transplantation setting, the prevalence of vitamin D deficiency is also high. Severe liver disease may increase the risk of vitamin D deficiency and vice versa, as there may be a relationship between vitamin D deficiency and fibrosis. In patients with chronic hepatitis C and those with recurrent of hepatitis C after liver transplantation, recent clinical data shows that a higher serum vitamin D level is an independent predictor of sustained virological response (SVR) following anti-viral therapy, and that a higher SVR is achieved with vitamin D supplementation.

Conclusions

Larger randomised clinical studies with adequate statistical power are needed to confirm these potentially very important nonskeletal effects of vitamin D in patients with chronic hepatitis C.

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