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Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study

BACKGROUND: Low serum vitamin D levels in chronic hepatitis C (CHC) is associated with advanced liver fibrosis; and there remains an imprecise relationship with the treatment response based on the vitamin D levels. Previous studies have shown conflicting results on the vitamin D levels, and associat...

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Autores principales: Gayam, Vijay, Mandal, Amrendra Kumar, Khalid, Mazin, Mukhtar, Osama, Gill, Arshpal, Garlapati, Pavani, Tiongson, Benjamin, Sherigar, Jagannath, Mansour, Mohammed, Mohanty, Smruti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089592/
https://www.ncbi.nlm.nih.gov/pubmed/30116431
http://dx.doi.org/10.14740/gr1072w
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author Gayam, Vijay
Mandal, Amrendra Kumar
Khalid, Mazin
Mukhtar, Osama
Gill, Arshpal
Garlapati, Pavani
Tiongson, Benjamin
Sherigar, Jagannath
Mansour, Mohammed
Mohanty, Smruti
author_facet Gayam, Vijay
Mandal, Amrendra Kumar
Khalid, Mazin
Mukhtar, Osama
Gill, Arshpal
Garlapati, Pavani
Tiongson, Benjamin
Sherigar, Jagannath
Mansour, Mohammed
Mohanty, Smruti
author_sort Gayam, Vijay
collection PubMed
description BACKGROUND: Low serum vitamin D levels in chronic hepatitis C (CHC) is associated with advanced liver fibrosis; and there remains an imprecise relationship with the treatment response based on the vitamin D levels. Previous studies have shown conflicting results on the vitamin D levels, and association with treatment response in CHC treated with interferon-based regimens. METHODS: Patients with CHC treated with direct-acting antivirals (DAAs) between January 2016 and December 2017 in the community clinic setting were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy with the sustained virologic response at 12 weeks post-treatment (SVR 12) were assessed in CHC patients with deficient, insufficient, and normal levels of vitamin D measured before the initiation of DAA therapy. RESULTS: Two hundred and ninety-one patients were included in the study. Direct-acting antivirals included in the study were ledipasvir/sofosbuvir ± ribavirin, ombitasvir + paritaprevir + ritonavir + dasabuvir ± ribavirin, and sofosbuvir/velpatasvir. An overall sustained virologic response was achieved in 95% (n = 276) of patients. SVR 12 rates among patients with vitamin D deficiency, vitamin D insufficiency and normal vitamin D levels were 92%, 96.2%, and 97.2% respectively and was not statically significant (P = 0.214). A total of 71 patients were cirrhotic. The prevalence of vitamin D insufficiency (20 - 29.9 ng/mL) and deficiency (< 20 ng/mL) was significantly higher in cirrhotic patients (P = 0.01). Despite this, pretreatment vitamin D levels did not show any impact on the virologic response. The most common adverse effect observed was fatigue. None of the patients had to discontinue the treatment due to adverse events. CONCLUSIONS: DAAs are safe and effective with a high overall SVR 12 in CHC and treatment response does not depend on the pretreatment vitamin D levels. The prevalence of both vitamin D insufficiency and deficiency was observed to be higher in cirrhotic cohorts compared to non-cirrhotic counterparts.
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spelling pubmed-60895922018-08-16 Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study Gayam, Vijay Mandal, Amrendra Kumar Khalid, Mazin Mukhtar, Osama Gill, Arshpal Garlapati, Pavani Tiongson, Benjamin Sherigar, Jagannath Mansour, Mohammed Mohanty, Smruti Gastroenterology Res Original Article BACKGROUND: Low serum vitamin D levels in chronic hepatitis C (CHC) is associated with advanced liver fibrosis; and there remains an imprecise relationship with the treatment response based on the vitamin D levels. Previous studies have shown conflicting results on the vitamin D levels, and association with treatment response in CHC treated with interferon-based regimens. METHODS: Patients with CHC treated with direct-acting antivirals (DAAs) between January 2016 and December 2017 in the community clinic setting were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy with the sustained virologic response at 12 weeks post-treatment (SVR 12) were assessed in CHC patients with deficient, insufficient, and normal levels of vitamin D measured before the initiation of DAA therapy. RESULTS: Two hundred and ninety-one patients were included in the study. Direct-acting antivirals included in the study were ledipasvir/sofosbuvir ± ribavirin, ombitasvir + paritaprevir + ritonavir + dasabuvir ± ribavirin, and sofosbuvir/velpatasvir. An overall sustained virologic response was achieved in 95% (n = 276) of patients. SVR 12 rates among patients with vitamin D deficiency, vitamin D insufficiency and normal vitamin D levels were 92%, 96.2%, and 97.2% respectively and was not statically significant (P = 0.214). A total of 71 patients were cirrhotic. The prevalence of vitamin D insufficiency (20 - 29.9 ng/mL) and deficiency (< 20 ng/mL) was significantly higher in cirrhotic patients (P = 0.01). Despite this, pretreatment vitamin D levels did not show any impact on the virologic response. The most common adverse effect observed was fatigue. None of the patients had to discontinue the treatment due to adverse events. CONCLUSIONS: DAAs are safe and effective with a high overall SVR 12 in CHC and treatment response does not depend on the pretreatment vitamin D levels. The prevalence of both vitamin D insufficiency and deficiency was observed to be higher in cirrhotic cohorts compared to non-cirrhotic counterparts. Elmer Press 2018-08 2018-02-08 /pmc/articles/PMC6089592/ /pubmed/30116431 http://dx.doi.org/10.14740/gr1072w Text en Copyright 2018, Gayam et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Gayam, Vijay
Mandal, Amrendra Kumar
Khalid, Mazin
Mukhtar, Osama
Gill, Arshpal
Garlapati, Pavani
Tiongson, Benjamin
Sherigar, Jagannath
Mansour, Mohammed
Mohanty, Smruti
Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study
title Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study
title_full Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study
title_fullStr Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study
title_full_unstemmed Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study
title_short Association Between Vitamin D Levels and Treatment Response to Direct-Acting Antivirals in Chronic Hepatitis C: A Real-World Study
title_sort association between vitamin d levels and treatment response to direct-acting antivirals in chronic hepatitis c: a real-world study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089592/
https://www.ncbi.nlm.nih.gov/pubmed/30116431
http://dx.doi.org/10.14740/gr1072w
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