Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2015; 21(4): 1284-1291
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1284
Vitamin D status and viral response to therapy in hepatitis C infected children
Azza A Eltayeb, Madleen Adel A Abdou, Amal M Abdel-aal, Mostafa H Othman
Azza A Eltayeb, Children University Hospital, Assiut University, 71515 Assiut, Egypt
Madleen Adel A Abdou, Amal M Abdel-aal, Assiut University Hospital, 71515 Assiut, Egypt
Mostafa H Othman, Department of Radiology, Assiut University hospital, 71515 Assiut, Egypt
Author contributions: Eltayeb AA participated in the sequence alignment, in the design and coordination of the study, and performed the statistical analysis and drafted the manuscript; Abdou MAA carried out the laboratory studies and participated in the sequence alignment; Abdel-aal AM carried out the laboratory studies and participated in the design of the study; Othman MH participated in the design of the study and the DEXA work in the study; all authors read and approved the final manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Azza A Eltayeb, Assistant Professor of Pediatric ICU, Children University Hospital, Assiut University, Qesm Than Asyut, 71515 Assiut, Egypt.
Telephone: +2-10-06863277 Fax: +2-88-2368371
Received: June 16, 2014
Peer-review started: June 17, 2014
First decision: July 21 ,2014
Revised: August 20, 2014
Accepted: September 29, 2014
Article in press: September 30, 2014
Published online: January 28, 2015

AIM: To study the frequency of vitamin D deficiency in patients with hepatitis C virus (HCV) infection and to evaluate the role of vitamin D supplementation in improving antiviral therapy.

METHODS: Sixty-six children aged from 7-14 years (mean ± SD, 11.17 ± 2.293) diagnosed with HCV infection were matched to 28 healthy controls. Serum levels of 25 (OH) D3, calcium, phosphorus, alkaline phosphatase and plasma level of parathormone were measured. Quantitative PCR for HCV was performed Bone density was determined by dual energy X-ray absorptiometry. All cases received conventional therapy, and only 33 patients received vitamin D supplementation.

RESULTS: Children with HCV showed significantly increased levels of HCV RNA (P < 0.001), parathormone (P < 0.01) and decreased vitamin D levels (P < 0.05) (33.3% deficient and 43.3% insufficient) compared with controls. Abnormal bone status (Z score -1.98 ± 0.75) was found in ribs, L-spine, pelvis and total body. Cases treated with vitamin D showed significant higher early (P < 0.04) and sustained (P < 0.05) virological response. There was a high frequency of vitamin D deficiency among the Egyptian HCV children, with significant decrease in bone density. The vitamin D level should be assessed before the start of antiviral treatment with the correction of any detected deficiency.

CONCLUSION: Adding vitamin D to conventional Peg/RBV therapy significantly improved the virological response and helped to prevent the risk of emerging bone fragility.

Keywords: Vitamin D, Viral response, Hepatitis C, Children

Core tip: Does vitamin D supplementation improves the viral response in hepatitis C infection? Previous studies raised the possibility that disease progression is associated with higher levels of vitamin D, and thus vitamin D supplementation does not have a role in chronic hepatitis C patients. This study aimed to investigate the frequency of vitamin D deficiency among Egyptian hepatitis C virus-infected children, with assessment of bone status by measuring calcium, parathormone and alkaline phosphatase levels, and bone mineral density and to evaluate the role of vitamin D supplementation in improving the viral response of these patients.