Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1325-1327
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1325
Hepatitis C infected patients need vitamin D3 supplementation in the era of direct acting antivirals treatment
Yasuteru Kondo
Yasuteru Kondo, Department of Hepatology, Sendai Kousei Hospital, Aoba, Sendai City 980, Miyagi, Japan
Author contributions: Kondo Y solely contributed to this manuscript.
Conflict-of-interest statement: None declared.
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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yasuteru Kondo, MD, PhD, Chief Director, Department of Hepatology, Sendai Kousei Hospital, 4-15 Hirosemachi, Aoba, Sendai City 980, Miyagi, Japan. yasuteru@ebony.plala.or.jp
Telephone: +81-22-2226181 Fax: +81-22-7138013
Received: October 22, 2016
Peer-review started: October 25, 2016
First decision: December 2, 2016
Revised: December 5, 2016
Accepted: December 21, 2016
Article in press: December 21, 2016
Published online: February 28, 2017
Processing time: 127 Days and 6 Hours
Abstract

It has been reported that the serum level of vitamin D3 (VitD3) could affect the natural course of chronic hepatitis C (CH-C) and the response to treatment with pegylated interferon (Peg-IFN) and ribavirin. Although several mechanisms for the favorable effects of VitD3 supplementation were reported, the total effect of VitD3 supplementation remains unclear. Previously, we reported that supplementation with 1(OH)VitD3 could enhance the Th1 response inducing not only a favorable immune response for viral eradication but also HCC control. Recently, the main treatment of CH-C should be direct acting antivirals (DAAs) without Peg-IFN. Peg-IFN is a strong immune-modulator. Therefore, an immunological analysis should be carried out to understand the effect of VitD3 after treatment of DAAs without Peg-IFN. The induction of a favorable immune response by adding VitD3 might be able to suppress the hepatocarcinogenesis after achieving SVR, especially in children and elderly patients with severe fibrosis lacking sufficient amounts of VitD3.

Keywords: Vitamin D; Hepatitis C virus; Direct acting antivirals; Hepatocarcinogenesis; Immune response

Core tip: Although several mechanisms for the favorable effects of vitamin D3 (VitD3) supplementation were reported, the total effect of VitD3 supplementation remains unclear. Recently, the main treatment of chronic hepatitis C should be direct acting antivirals (DAAs) without pegylated interferon (Peg-IFN). Peg-IFN is a strong immune-modulator. Therefore, an immunological analysis should be carried out to understand the effect of VitD3 after treatment of DAAs without Peg-IFN. The induction of a favorable immune response by adding VitD3 might be able to suppress the hepatocarcinogenesis after achieving SVR, especially in children and elderly patients with severe fibrosis lacking sufficient amounts of VitD3.