Vitamin A deficiency is associated with hepatitis C virus chronic infection and with unresponsiveness to interferon-based antiviral therapy
Vitamin A deficiency is associated with hepatitis C virus chronic infection and with unresponsiveness to interferon-based antiviral therapy
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DOI：
10.1002/hep.26186
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发表时间：
2013-03-01
期刊：
影响因子：
13.5
通讯作者：
Toniutto, Pierluigi
中科院分区：
文献类型：
--
作者：
Bitetto, Davide;Bortolotti, Nadia;Toniutto, Pierluigi
最近的数据表明，维生素A调节I型干扰素受体的表达，增强干扰素对丙型肝炎病毒（HCV）的抗复制作用。本研究旨在调查慢性HCV感染患者中维生素A缺乏的患病率，并评估维生素A缺乏是否与干扰素抗病毒治疗无反应有关。该分析包括199名连续的未经治疗的慢性HCV患者，其中治疗前血清维生素A和25-OH维生素D进行了测量; 119名健康献血者作为对照。HCV阳性患者血清维生素A中位数（四分位距）显著低于对照组：256 ng/mL（128-440）vs 742（624-942，P < 0.0001）。在122/199例患者中实现了总体持续病毒应答，其中46/109例感染了难以治疗的HCV基因型。在后者中，39/104（37.5%）为无应答者。在多变量分析中，携带白细胞介素（IL）-28 B T/* 基因型、基线血清GT >60 IU/mL、HCV RNA > 600，000 IU/mL、维生素A 100 ng/mL和利巴韦林累积剂量80%可预测抗病毒治疗无效。17例患者（9.0%）血清维生素A水平100 ng/mL和维生素D 20 ng/mL;维生素A和D联合缺乏的存在被认为是抗病毒治疗无反应的一个强有力的独立预测因素。结论：慢性HCV感染者血清维生素A缺乏率高。这种情况与抗病毒治疗无反应有关。（肝脏学2013）
Recent data suggest that vitamin A modulates the expression of type I interferon receptor enhancing the antireplication effect of interferon- on hepatitis C virus (HCV). This study aimed to investigate the prevalence of vitamin A deficiency among patients with chronic HCV infection and to assess whether vitamin A deficiency could be associated with unresponsiveness to interferon-based antiviral therapy. The analysis included 199 consecutive treatment-naive chronic HCV patients in whom pretreatment serum vitamin A and 25-OH vitamin D were measured; 119 healthy blood donors were used as controls. Median (interquartile range) serum vitamin A in HCV-positive patients was significantly lower than in controls: 256 ng/mL (128-440) versus 742 (624-942, P < 0.0001). Overall sustained viral response was achieved in 122/199 patients, 46/109 infected by difficult to treat HCV genotypes. In these latter, 39/104 (37.5%) were nonresponders. At multivariate analysis, nonresponse to antiviral therapy was predicted by carriage of interleukin (IL)-28B T/* genotypes, baseline serum levels of GT >60 IU/mL, of HCV RNA >600,000 IU/mL, of vitamin A 100 ng/mL, and a cumulative dose of ribavirin 80%. Seventeen patients (9.0%) had both serum levels of vitamin A 100 ng/mL and of vitamin D 20 ng/mL; the presence of a combined vitamin A and D deficiency was found to be a strong independent predictor of nonresponse to antiviral therapy. Conclusion: A high percentage of patients with chronic HCV infection have serum vitamin A deficiency. This condition is associated with nonresponse to antiviral therapy. (HEPATOLOGY 2013)