The Clinical Utility of Vitamin D Levels in Management of Treatment Naive Chronic HCV Infection

Background Hepatitis C virus (HCV) is a major cause of chronic hepatitis and the leading cause of end stage liver disease including liver cirrhosis and hepatocellular carcinoma. The best predictor of long-term response for chronic hepatitis C (CHC) to treatment is sustained virological response (SVR). Two major predictors of SVR are genotypes and viral load4. Recently emerged predictor of response to antiviral treatment is serum vitamin D concentration. Vitamin D plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). Patients with chronic hepatitis C (CHC) frequently suffer from severe vitamin D deficiency. AIMS AND OBJECTIVES To evaluate the clinical utility of vitamin D levels in management of treatment naive HCV infection. To correlate between serum vitamin D levels and HCV RNA viral load in patients with chronic hepatitis C infection. MATERIALS AND METHODS Study was conducted in the department of Gastroenterology, Yashoda Hospital, Hyderabad from November 2014 to March 2016. Informed consent of the study participants was obtained in all cases. The study had approval of local Ethical Committee. We screened 65 patients for the study and a total of 50 treatment nave chronic hepatitis C (CHC) patients were included in this study. Data was collected prospectively from consecutive patients from both outdoor and indoor patients based on clinical interview and review of records. Detailed history and systemic examination was done. Blood samples were obtained for complete blood count, renal function test, liver function test, Thyroid function tests, and serum calcium levels. Blood samples were taken for vitamin D levels, quantitative HCV RNA levels for CHC patients. RESULTS A total off 50 patients were selected in hepatitis C group according to the inclusion criteria. Out of 50 patients 33 were males and 17 were females with mean age of 52.7 8.5) years. Mean serum vitamin D concentrations of entire cohort was 21.115.2) ng/ml. Mean HCV RNA of the entire cohort was 3.42.2) log10IU/ml. Of the 55 patients of the entire cohort, 09 (18 %) had severe vitamin D deficiency [25 (OH) D