Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1284
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.
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.