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Effect of vitamin D supplementation on pegylated interferon/ribavirin therapy for chronic hepatitis C genotype 1b: a randomized controlled trial
Author(s) -
Yokoyama S.,
Takahashi S.,
Kawakami Y.,
Hayes C. N.,
Kohno H.,
Kohno H.,
Tsuji K.,
Aisaka Y.,
Kira S.,
Yamashina K.,
aka M.,
Moriya T.,
Kitamoto M.,
Aimitsu S.,
Nakanishi T.,
Kawakami H.,
Chayama K.
Publication year - 2014
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12146
Subject(s) - ribavirin , medicine , vitamin d and neurology , gastroenterology , pegylated interferon , vitamin , hepatitis c virus , viral load , randomized controlled trial , adverse effect , vitamin d deficiency , hepatitis c , immunology , virus
Summary Chronic HCV –infected patients tend to have vitamin D deficiency, suggesting that vitamin D supplementation may enhance the efficacy of treatment with pegylated interferon ( PEG ‐ IFN ) and ribavirin ( RBV ). We therefore assessed the effects of vitamin D supplementation on viral response to PEG ‐ IFN / RBV . Eighty‐four patients with HCV genotype 1b were randomized, 42 to oral vitamin D supplementation (1000 IU/day) and 42 to nonsupplementation (control), from week 8 to the end of PEG ‐ IFN / RBV therapy. The primary end point was undetectable HCV RNA at week 24 (viral response [ VR ]). VR rate at week 24 was significantly higher in the vitamin D than in the control group (78.6% vs 54.8% P = 0.037). Adverse events were similar in both groups. When patients were subdivided by IL 28B SNP rs8099917 genotype, those with the TT genotype group showed a significantly higher VR rate at week 24 with than without vitamin D supplementation (86.2% vs 63.3% vs P = 0.044). Although patients with the TG / GG genotype, who were relatively resistant to PEG ‐ IFN treatment, had similar VR rates at week 24 with and without vitamin D supplementation, the decline in viral load from week 8 to week 24 was significantly greater with than without vitamin D supplementation. Multivariate analysis showed that rs8099917 genotype and vitamin D supplementation contributed significantly to VR at week 24. SVR rates were similar in the vitamin D and control groups [64.3% (27/42) vs 50% (21/42), P = 0.19]. Vitamin D supplementation may enhance the effects of PEG ‐ IFN / RBV in HCV genotype 1b–infected patients.