Prevalence of Vitamin D Deficiency among Non-cirrhotic Pakistani Patients with Chronic Viral Hepatitis and Non-alcoholic Fatty Liver Disease

Abstract

Introduction: Vitamin D deficiency is common among patients with chronic viral hepatitis and nonalcoholic fatty liver disease (NAFLD). There is no published data on vitamin D levels in Pakistani patients with chronic viral hepatitis or NAFLD. Objective: To determine the prevalence of vitamin D deficiency in Pakistani patients with chronic viral hepatitis B and C and NAFLD. Methods: Patients with chronic viral hepatitis B and C but not cirrhosis were prospectively tested for vitamin D levels. 25- hydroxyvitamin D levels were measured using a direct competitive immunoluminometric assay. Results: Of the 400 patients enrolled in the study, 110 (27%) had chronic hepatitis B and 190 (48%) had chronic hepatitis C and 100 (25%) had NAFLD. 224 (56%) patients were male and the average age was 52 years. Overall, 154 (39%) had vitamin D deficiency (<10 ng/ml), 212 (53%) had vitamin D insufficiency (10-30 ng/ml), and 34 (8%) were vitamin D sufficient (>30 ng/ml). Among chronic hepatitis C patients, 59 (31%) were vitamin D deficient and 112 (59%) were vitamin D insufficient. Of chronic hepatitis B patients, 52 (47%) were vitamin D deficient and 51 (46%) were vitamin D insufficient. Among NAFLD patients, 43 (43%) were vitamin D deficient, 49 (49%) were vitamin D insufficient. Conclusion: Vitamin D deficiency or insufficiency affects greater than 90% of non-cirrhotic, chronic viral hepatitis and NAFLD patients in Pakistan. Further studies are needed to assess this problem in a larger cohort of patients and in cirrhotic patients, and to determine its impact on treatment outcomes in Pakistani patients.