The Correlation Of Vitamin D Levels With Virological Parameters In Patients With Treatment Naive Chronic Hepatitis B Infection

Hilal Ahmad Tali; Rubiya Ryhan; Falak Ara; Irshad Ahmad Tali

Volume : VIII, Issue : IV, April - 2019

The Correlation Of Vitamin D Levels With Virological Parameters In Patients With Treatment Naive Chronic Hepatitis B Infection

Hilal Ahmad Tali, Rubiya Ryhan, Falak Ara, Irshad Ahmad Tali

Abstract :

Hepatitis B virus infection is associated with a significant risk of developing cirrhosis, and hepatocellular carcinoma. Most patients need life–long therapy with Nucleotide Analogs.The development of novel immunomodulatory approaches to control HBV infection, appears to be highly relevant. Cholecalciferol is the precursor of the bioactive calcitriol serves as an important modulator of numerous signaling pathways related to both innate and adaptive immunity.Therapeutic value of the immunomodulatory effect of vitamin D has been proven. AIMS AND OBJECTIVES: The aim of this study is to evaluate the clinical utility of vitamin D levels in management of treatment naive chronic HBV infection.To correlate between serum vitamin D levels and HBV DNA viral load in patients with chronic hepatitis B infection. MATERIALS AND METHODS: Study was conducted in the department of Gastroenterology, Yashoda Hospital, Hyderabad from November 2014 to March 2016. A total of 55 treatment naive chronic hepatitis B (CHB) patients were included in this study.Data was collected prospectively from consecutive patients.Blood samples were taken for vitamin D levels, quantitative HBV DNA, HBeAg for CHB patients.Quantitative HBV DNA levels were done by ABI real time PCR.25–Hydroxy Vitamin D 25(OH)D levels were done by EIA. RESULTS A total of 55 patients, 36 were males and 19 were females with mean age of 43 (�14) years . The Mean serum vitamin D concentrations of entire cohort was 20.4�15.7) ng/ml. 17 (31%) had severe vitamin D deficiency [25(OH)D <10ng/ml].Patients having HBV DNA levels > 20,000 IU/ml had significantly low serum vitamin D levels compared to patients with serum HBV DNA levels <20,000IU/ml (p <0.0001).The mean serum vitamin D level in HBeAg positive patients was 6.65(2.63) and in HBeAg negative patients was 33.57(14.85)(p<0.0003).The mean vitamin D serum concentrations in autumn–winter and spring–summer months were 12.4 � 4.2 and 20.6 � 2.2 ng/ml, respectively (p < 0.0001). CONCLUSION: 1. HBV DNA viral load appears to be the strongest determinant of low 25(OH)D serum levels in treatment na�ve CHB patients. 2. HBV DNA viral load appear to have an inverse relationship with serum vitamin D levels. 3. HBeAg positive CHB patients appear to be more deficient in serum vitamin D as compared to HBeAg negative patients. 4. Serum Vitamin D levels appears to have significant seasonal fluctuations.