Review
Copyright ©The Author(s) 2018.
World J Gastroenterol. Jan 28, 2018; 24(4): 445-460
Published online Jan 28, 2018. doi: 10.3748/wjg.v24.i4.445
Table 1 Representative studies on vitamin D deficiency in chronic hepatitis B virus patients
Study populationDiagnosisSample size (n)Study designLength of follow-upVitamin D cutoff (ng/mL)(%)Main resultsRef.
China CHB (n = 560)Multicenter, randomized, controlled104 wk from initiation of antiviral treatment< 20: deficiency < 30: insufficiency ≥ 30: sufficiency21 55 24Vitamin D insufficiency highly prevalent in treatment-naïve patients with chronic hepatitis B Baseline levels predict virologic response at week 104 after treatment initiation (67% in the insufficiency group vs 82% in the sufficient group)Yu et al[29], 2017
China CHB (n = 133)Cross-sectionalNA< 14: severe deficiency ≥ 14: deficiency < 30 sufficiency27 66 7Vitamin D deficiency significantly associated with HBV genotype BZhu et al[93], 2016
Vietnam CHB (n = 165) LC (n = 127) HCC (n = 108)Cross-sectionalNA< 10: severe deficiency < 20: deficiency < 30: insufficiency ≥ 30: sufficiency10.4 41.5 32.4 15.7Vitamin D insufficiency frequent among HBV patients Reduced vitamin D levels significantly associated with clinical progression of LC Vitamin D levels and HBV DNA loads strongly and inversely correlatedHoan et al[4], 2016
China CHB (n = 115) LC ( = 115) HC ( = 115)Cross-sectionalNA< 10: deficiency < 20: insufficiency ≥ 20: sufficiency83 17 0Vitamin D levels significantly lower in LC compared to CHB and HC groups (P < 0.001) Child-Pugh score independently associated with vitamin D deficiency (cutoff < 10  ng/mL)Zhao et al[5], 2016
South Korea CHB (n = 110) Other CLD (n = 97)Cross-sectionalNA< 10: deficiency < 20: insufficiency ≥ 20: sufficiency34.8 45.4 19.8Vitamin D deficiency independently associated with advanced liver fibrosisKo et al[154], 2016
Iran CHB (n = 84)Cross-sectionalNA< 10: deficiency < 20: insufficiency ≥ 20: sufficiency17.9 34.5 47.6No significant association of vitamin D levels in treated and treatment-naïve patientsSali et al[155], 2016
Multicenter in Europe, Asia and North America CHB (n = 737)Randomized, open-label, active-controlled clinical trial48 wk of TDF + PegIFN 16 wk of TDF + PegIFN followed by 32 wk of TDF 48 wk PegIFN or 120 wk of TDF< 20: deficiency < 30: insufficiency ≥ 30: sufficiency58 35 7Reduced vitamin D levels highly prevalent among untreated CHB patients Low baseline levels of vitamin D associated with high HBV DNA loads, abnormal ALT at week 48 independent of treatment groups Baseline vitamin D levels not associated with treatment outcomesChan et al[19], 2015
China CHB (n = 426)Cross-sectionalNA< 32 insufficiency ≥ 32 sufficiency82 18Vitamin D deficiency common among patients with CHB and associated with adverse clinical outcomesWong et al[78], 2015
China CHB (n = 242)Cross-sectionalNA< 20: deficiency < 30: insufficiency ≥ 30: sufficiency8.7 31.4 60Higher prevalence of vitamin D insufficiency in HBV genotype B patients than in genotype C patients Vitamin D levels not associated with HBV DNA levels or the stage of fibrosis in CHB patientsYu et al[23], 2015
China CHB (n = 133)Cross-sectionalNA< 14: deficiency < 30: insufficiency ≥ 30: sufficiency27 66.2 6.8Higher prevalence of vitamin D insufficiency in HBV genotype B patients than in genotype C patients Vitamin D levels not associated with other clinical parametersZhu et al[93], 2016
Germany CHB (n = 203)Cross-sectionalNA< 10: deficiency < 20: insufficiency ≥ 20: sufficiency34 47 19HBV DNA viral loads as strong predictor of low vitamin D levels in CHB patientsFarnik et al[12], 2013
Egypt OBI (n = 16) CHB (n = 52)Cross-sectionalNA< 10: deficiency < 30: insufficiency ≥ 30: sufficiencyOBI: 12.5 CHB: 40.4 OBI: 62.5 CHB: 59.6 OBI: 25 CHB: 0Vitamin D levels significantly higher in OBI than in CHB patients Serum level of vitamin D inversely correlated with HBV DNA loadsMashaly et al[156], 2016
China CHB (n = 128)Cross-sectionalNA< 10: deficiency < 20: insufficiency ≥ 20: sufficiency13.3 61.7 25Vitamin D levels negatively correlated with HBV DNA loads Effective antiviral therapy might increase the level of vitamin D in CHB patientsChen et al[11], 2015
Iran CHB (n = 173)Cross-sectionalNA< 10: deficiency < 20: insufficiency ≥ 20: sufficiency58 39 3Vitamin D levels inversely correlated with HBV DNA levelsMohamadkhani et al[89], 2015