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Association between vitamin D deficiency and pre‐existing resistance‐associated hepatitis C virus NS5A variants
Author(s) -
Okubo Tomomi,
Atsukawa Masanori,
Tsubota Akihito,
Shimada Noritomo,
Abe Hiroshi,
Yoshizawa Kai,
Arai Taeang,
Nakagawa Ai,
Itokawa Norio,
Kondo Chisa,
Aizawa Yoshio,
Iwakiri Katsuhiko
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12784
Subject(s) - ns5a , virology , medicine , vitamin d deficiency , hepatitis a virus , hepatitis c virus , virus , biology , vitamin d and neurology , hepacivirus
Aim Although interferon‐free therapy with direct‐acting antivirals has developed as a standard of care for chronic hepatitis C, the existence of resistance‐associated variants (RAVs) has a negative impact on treatment results. Recently, several studies indicated a relationship between chronic hepatitis C and serum vitamin D levels. However, the relationship between RAVs at the hepatitis C virus non‐structure 5A (NS5A) region and serum vitamin D level has not yet been examined. Methods Among patients with genotype 1 chronic hepatitis C who were enrolled in a multicenter cooperative study, our subjects comprised 247 patients in whom it was possible to measure RAVs at the NS5A region. These RAVs were measured using a direct sequencing method. Results The median age of patients was 70 years (range, 24–87 years), and the number of female patients was 135 (54.7%). The median serum 25(OH) D3 level was 22 ng/mL (range, 6–64 ng/mL). L31 and Y93 RAVs at the NS5A region were detected in 3.7% (9/247) and 13.4% (33/247) of patients, respectively. Multivariate analysis identified vitamin D deficiency (serum 25(OH) D3 ≤ 20 ng/mL) ( P = 5.91 × 10⁻ 5 , odds ratio = 5.015) and elderly age (>70 years) ( P = 1.85 × 10 −3 , odds ratio = 3.364) as contributing independent factors associated with the presence of the L31 and/or Y93 RAVs. The Y93H RAV was detected in 25.9% (29/112) of patients with a vitamin D deficiency, and in 8.9% (12/135) of those with a serum 25(OH) D3 level >20 ng/mL ( P = 4.90 × 10 −3 ). Conclusion We showed that RAVs at the NS5A region are associated with vitamin D deficiency and elderly age, which may have a negative influence on innate/adaptive immune responses to hepatitis C virus infection.