Vitamin D deficiency is associated with severity of liver disease in HIV/HCV coinfected patients

Abstract

To study the association of plasma 25-hydroxy vitamin D (25(OH)D) levels in HIV/HCV coinfected patients with severity of liver disease and virological response to hepatitis C virus (HCV) therapy with pegylated-interferon-alpha plus ribavirin (pegIFNα/RBV). A cross-sectional study in 174 HIV/HCV coinfected patients that underwent a liver biopsy previously to start HCV therapy and a retrospective study of 125 of them. Plasma 25(OH)D levels were quantified by enzyme immunoassay. Liver biopsies were evaluated by METAVIR score. A sustained virological response (SVR) was defined as an undetectable serum HCV viral load (<10IU/mL) up through 24 weeks after the end of HCV treatment. The median of plasma 25(OH)D level was 48nmol/L (p25th: 32.5; p75th: 56.1) and 27 (15.5%) had 25(OH)D deficiency (<25nmol/L). The percentage of 25(OH)D deficiency was higher in patients with significant fibrosis (F≥2) (92.6% vs. 57.1%; p=0.010) and moderate necroinflammatory activity grade (A≥2) (85.2% vs. 60%; p=0.043). However, adjusted logistic regression analyses showed that 25(OH)D deficiency was only associated with severity of liver disease [F≥2 (OR=8.47 (95% of confidence interval (CI)=1.88; 38.3); p=0.005) and A≥2 (OR=3.25 (95%CI=1.06; 10.1); p=0.040)]. Moreover, any significant relationship was found between 25(OH)D deficiency and SVR after HCV therapy. Plasma 25(OH)D deficiency was associated with liver disease severity in HIV/HCV coinfected patients, but it was not associated with HCV treatment failure.