1. BACKGROUND MATERIALS & METHODS RESULTS CONCLUSIONS
1Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute, 2Endemic Medicine Department, 3Biochemistry Department, Cairo University, 4 Biochemistry Department, National Hepatology and Tropical Medicine Research Institute, 5Public Health and Community Medicine Department, Cairo University, Cairo, Egypt
EFFECT OF VITAMIN D SUPPLEMENTATION ON SUSTAINED VIROLOGICAL RESPONSE TO PEGINTERFERON ALFA-2B / RIBAVIRIN COMBINATION IN CHRONIC HEPATITIS C GENOTYPE 4
M. Hassany1, G. Esmat2, M. El Raziky2, W. Doss1, D. Sabry3, A. Ahmed4, N. Assem5, A. El Sharkawy2, M. El Kassas1
BACKGROUND
MATERIALS & METHODS
RESULTS
HCV infection is the main cause of chronic liver diseases worldwide. The current standard treatment for chronic HCV(Peg-IFN/RBV)is not satisfactory especially with the moderate response rates and currently known side effects for the treatment. Many coming reports showed the possible role of vitamin D supplementation in augmenting the response to standard of care (SOC) therapy of HCV.
-101 chronic HCV patients classified into two groups: (Group 1) : Received the SOC therapy consisted of Peg-Interferon α 2b (1.5μg/kg)+Ribavirin( mg according to body weight) - (51 patients).
(Group 2): Received the SOC therapy consisted of Peg-Interferon α 2b (1.5 μg/kg+Ribavirin( mg according to body weight) + Vitamin D (50 patients).
Vitamin D3 (Cholecalciferol) was administered in the form of oral drops in a dose of IU/Week started from week 0 till the treatment end.
Vitamin D (25 OH D) levels were assessed serially at weeks 0,6,12,24 and 48 to ensure adequate supplementation
Median baseline 25 (OH) D levels at different fibrosis grades.
Treatment outcomes by intention to treat analysis
Treatment outcomes by per-protocol analysis
Mean 25(OH) D levels in group 2 throughout the study period
Vitamin D deficiency was found in 100 % of group 1 patients and in 90% of group 2 patients .After Vitamin D supplementation and optimization of the serum levels, no positive impact was reflected on treatment outcome where SVR was achieved in 71.4% in group 1 and in % in group 2 by per-protocol analysis (p=0.22) ; in 68.6 % in group 1 and 44% in group 2 by intention to treat analysis (p=0.22) with no statistically significant differences. Also no correlation was found between 25(OH) D levels and fibrosis score (p=0.25) at baseline assessment of the whole 101 studied populations
CONCLUSIONS
CORRESPONDING AUTHOR
OBJECTIVES
Despite the optimistic data previously documented about the results of vitamin D supplementation on HCV treatment ,in the current study no significant impact on SVR rates and no solid correlation was found between vitamin D levels and degree of liver fibrosis.
Mohamed Hassany.
Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo .Egypt.
1-Determine the incidence of Vitamin D deficiency in chronic HCV Genotype 4 patients .
2-Comparison of (SVR) between SOC group and SOC plus Vit. D group.
3-Determine the correlation between Vit D deficiency and the degree of hepatic fibrosis.