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Can adding vitamin D improve response to HCV antiviral therapy?

In this recent report published in the World Journal of Gastroenterology, researchers in Safed, Israel conducted a study "To determine whether adding vitamin D, a potent immunomodulator, improves the hepatitis C virus (HCV) response to antiviral therapy.

Seventy-two consecutive patients with chronic HCV genotype 1 were randomized into two groups:

the treatment group (n = 36, 50% male, mean age 47 +/- 11 years) received Peg-alpha-2b interferon (1.5 mu g/kg per week) plus ribavirin (1000-1200 mg/d) together with vitamin D3 (2000 IU/d, target serum level > 32 ng/mL), and

the control group (n = 36, 60% male, mean age 49 +/- 7 years) received identical therapy without vitamin D.

"The sustained virologic response (SVR) was defined as undetectable HCV-RNA at 24 wk post-treatment. Clinical characteristics were similar in both groups. The treatment group had a higher mean body mass index (27 +/- 4 kg/m(2) vs 24 +/- 3 kg/m(2), viral load (50% vs 42%, and fibrosis score (> F2: 42% vs 19%, ) than the controls.

At week 4, 16 (44%) treated patients and 6 (17%) controls were HCV-RNA negative.

At week 12, 34 (94%) treated patients and 17 (48%) controls were HCV-RNA negative.

At 24 wk post-treatment (SVR), 31 (86%) treated patients and 15 (42%) controls were HCV-RNA negative.

Viral load, advanced fibrosis and vitamin D supplementation were strongly and independently associated with SVR. Adverse events were mild and typical of Peg-alpha-2b/ribavirin," wrote S. Abu-Mouch and colleagues, Technion-Israel Institute of Technology.

The researchers concluded: "Adding vitamin D to conventional Peg-alpha-2b/ribavirin therapy for treatment-naive patients with chronic HCV genotype 1 infection significantly improves the viral response."

Abu-Mouch and colleagues published their study in World Journal of Gastroenterology (Vitamin D supplementation improves sustained virologic response in chronic hepatitis C (genotype 1)-naive patients. World Journal of Gastroenterology, 2011;17(47):5184-5190).

For additional information, contact S. Abu-Mouch, Technion Israel Inst Technol, Liver Unit, Ziv Med Center, IL-13100 Safed, Israel.