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Efficacy of vitamin D supplementation in combination with conventional antiviral therapy in patients with chronic hepatitis C infection: a meta‐analysis of randomised controlled trials
Author(s) -
Kim H.B.,
Myung S.K.,
Lee Y.J.,
Park B.J.
Publication year - 2018
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12503
Subject(s) - medicine , ribavirin , meta analysis , pegylated interferon , cochrane library , hepatitis c , randomized controlled trial , vitamin d and neurology , combination therapy , confidence interval , gastroenterology , hepatitis c virus , immunology , virus
Background Although a contributory role of vitamin D levels for the development of chronic hepatitis C has been suggested, the efficacy of vitamin D supplementation in combination with conventional antiviral therapy consisting of pegylated interferon‐α (Peg‐ IFN ‐α) injection and oral ribavirin ( RBV ) remains unclear. We investigated its efficacy in the treatment of chronic hepatitis C via a meta‐analysis of randomised controlled trials. Methods We searched PubMed, EMBASE , the Cochrane Library, ClinicalTrials.gov and the bibliographies of relevant articles to locate additional publications in September 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria. Results Of 522 articles meeting our initial criteria, a total of seven open‐label, randomised controlled trials involving 548 participants, were included in the final analysis. Vitamin D supplementation in combination with Peg‐ IFN ‐α injection and oral RBV significantly increased the rate of viral response for hepatitis C at 24 weeks after treatment in a random‐effects meta‐analysis (relative risk = 1.30; 95% confidence interval = 1.04–1.62; I 2 = 75.9%). Also, its significant efficacy was observed in patients with hepatitis C virus genotype 1, which is known to be refractory to antiviral therapy. Conclusions In summary, we observed that additional use of vitamin D has a positive effect on sustained viral response rates of patients with chronic hepatitis C infection. However, we cannot establish the efficacy because of substantial heterogeneity, a small sample size and a low methodological quality.