Low Vitamin D Serum Concentration Is Associated With High Levels of Hepatitis B Virus Replication in Chronically Infected Patients

作者：Farnik Harald; Bojunga Joerg; Berger Annemarie; Allwinn Regina; Waidmann Oliver; Kronenberger Bernd; Keppler Oliver T; Zeuzem Stefan; Sarrazin Christoph; Lange Christian M^*

来源：Hepatology, 2013, 58(4): 1270-1276.

DOI：10.1002/hep.26488

Vitamin D is an important immune modulator that plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). In contrast, the relationship between vitamin D metabolism and chronic hepatitis B (CHB) is less well characterized. Therefore, we quantified 25(OH)D-3 serum levels in a cohort of 203 treatment-naive patients with chronic hepatitis B virus (HBV) infection and tested for their association with clinical parameters of CHB. Of 203 patients, 69 (34%), 95 (47%), and 39 (19%) had severe vitamin D deficiency (25(OH)D-3 %26lt;10 ng/mL), vitamin D insufficiency (25(OH)D-3 10 and %26lt;20 ng/mL), or adequate vitamin D serum levels (25(OH)D-3 20 ng/mL), respectively. In both uni- and multivariate analyses, HBV DNA viral load (log(10) IU/mL) was a strong predictor of low 25(OH)D-3 serum levels (P=0.0007 and P=0.000048, respectively) and vice versa. Mean 25(OH)D-3 serum concentrations in patients with HBV DNA %26lt;2,000 versus 2,000 IU/mL were 17 versus 11 ng/mL, respectively (P%26lt;0.00001). In addition, hepatitis B early antigen (HBeAg)-positive patients had lower 25(OH)D-3 serum levels than HBeAg-negative patients (P=0.0013). Finally, 25(OH)D-3 and HBV DNA serum levels showed inverse seasonal fluctuations. Conclusion: Low 25(OH)D-3 serum levels are associated with high levels of HBV replication in patients with CHB. This represents a major difference from chronic hepatitis C, where numerous previous studies have shown a lack of correlation between HCV viral load and vitamin D serum levels. Inverse seasonal fluctuations of 25(OH)D-3 and HBV DNA serum levels are suggestive of a functional relationship between both variables. (Hepatology 2013;58:1270-1276)

• 出版日期2013-10
• 单位河北医科大学