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Abstract Details
Vitamin A deficiency is associated with HCV chronic infection and with unresponsiveness to interferon based antiviral therapy
Bitetto D, Bortolotti N, Falleti E, Vescovo S, Fabris C, Fattovich G, Cussigh A, Cmet S, Fornasiere E, Ceriani E, Pirisi M, Toniutto P. Hepatology. 2012 Dec 5. doi: 10.1002/hep.26186. [Epub ahead of print]
Source
Department of Medical Sciences Experimental and Clinical, Medical Liver Transplantation Unit, Internal Medicine, University of Udine, Italy.
Abstract
Recent data suggest that vitamin A modulate the expression of type I interferon receptor enhancing the anti replication effect of interferon-α on hepatitis C virus (HCV). This study aimed to investigate the prevalence of vitamin A deficiency among patients with chronic HCV infection and to assess whether vitamin A deficiency could be associated with unresponsiveness to interferon based antiviral therapy. The analysis included 199 consecutive treatment-naïve chronic hepatitis C patients in whom pre-treatment serum vitamin A and 25-OH vitamin D were measured; 119 healthy blood donors were used as controls. Median (inter-quartile range) serum vitamin A in HCV positive patients was significantly lower than in controls: 256 ng/mL (128-440) Vs 742 (624-942, p<0.0001). Overall sustained viral response was achieved in 122/199 patients, 46/109 infected by difficult to treat HCV genotypes. In these latter, 39/104 (37.5%) were non responders. At multivariate analysis, non response to antiviral therapy was predicted by carriage of IL-28B T/* genotypes, baseline serum levels of γGT >60 IU/mL, of HCV RNA >600.000 IU/mL, of vitamin A ≤100 ng/mL and the cumulative dose of ribavirin ≤80%. Seventeen patients (9.0%) had both serum levels of vitamin A ≤100 ng/mL and of vitamin D ≤20 ng/mL; the presence of the combined vitamin A and D deficiency was found to be a strong independent predictor of non response to antiviral therapy. Conclusions: a high percentage of patients with chronic HCV infection present serum vitamin A deficiency. This condition is associated with non response to antiviral therapy.