Association of serum vitamin B12 levels with stage of liver fibrosis and treatment outcome in patients with chronic hepatitis C virus genotype 1 infection: a retrospective study.
Association of serum vitamin B12 levels with stage of liver fibrosis and treatment outcome in patients with chronic hepatitis C virus genotype 1 infection: a retrospective study.
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DOI：
10.1186/s13104-015-1248-z
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发表时间：
2015-06-25
影响因子：
1.8
通讯作者：
Amanzada, Ahmad
中科院分区：
文献类型：
--
作者：
Mechie, Nicolae-Catalin;Goralzcyk, Armin D;Amanzada, Ahmad
背景：慢性丙型肝炎（CHC）是一个全球性的健康挑战。具有良好持续病毒学应答（SVR）率的新治疗药物主要在发达国家可用，而大多数CHC患者生活在卫生预算较低的国家。因此，治疗反应的预测是必要的。维生素B12似乎参与丙型肝炎病毒replication.METHODS：因此，我们回顾性研究了基线血清维生素B12水平和临床特征之间的关系，在116 CHC基因型1感染的患者。统计分析采用单变量和多变量逻辑回归模型。结果：基线血清维生素B12水平与血清转氨酶活性呈正相关（AST，p = 0.002，ALT，p = 0.04），基线病毒载量（p <0.0001），纤维化分期（p = 0.0001）和有利的干扰素β 3/4（IFNL3/IFNL4）rs12979860基因型（p = 0.04），与SVR（p <0.001）以及快速病毒学应答（p = 0.001）成反比。基线血清维生素B12水平低于临界值570 ng/L的患者与高于临界值的患者相比，SVR率为59%，比值比（OR）为13.4 [置信区间（CI）4.3 - 41.9，p <0.0001]。通过结合血清维生素B12水平和IFNL3/IFNL4 rs12979860基因型，基线血清维生素B12水平低于570 ng/L临界值和IFNL3/IFNL4 rs12979860 CC基因型的患者获得了甚至80%的SVR率，OR为54（CI 9.9 - 293，p <0.0001）与高于临界值和非CC-genotype.CONCLUSION的患者相比：我们的数据表明基线血清维生素B12水平是表征CHC患者的有用的非侵入性标志物。它们可能进一步有助于识别标准治疗的反应者。
BACKGROUND: Chronic hepatitis C (CHC) is a global health challenge. New therapeutic agents with excellent sustained virological response (SVR) rates are available mainly in developed countries, while the majority of CHC patients live in countries with low health budget. Predictors of therapeutic response are therefore necessary. Vitamin B12 appears to be involved in hepatitis C virus replication.METHODS: We therefore studied retrospectively the relationship between baseline serum vitamin B12 levels and clinical features in 116 CHC genotype 1 infected patients. Logistic regression models with univariate and multivariate analysis were used in the statistical analysis.RESULTS: Baseline serum vitamin B12 levels were found to be positively associated with serum transaminase activities (AST, p = 0.002, ALT, p = 0.04), baseline viral load (p < 0.0001), stage of fibrosis (p = 0.0001) and favorable interferon-lambda3/4 (IFNL3/IFNL4) rs12979860 genotypes (p = 0.04), and inversely with SVR (p < 0.001) as well as with rapid virological response (p = 0.001). Patients with baseline serum vitamin B12 levels below a cut-off value of 570 ng/L achieved a SVR rate of 59% with an odds ratio (OR) of 13.4 [confidence interval (CI) 4.3-41.9, p < 0.0001] compared to patients above the cut-off value. By combining serum vitamin B12 levels and IFNL3/IFNL4 rs12979860 genotypes, patients with baseline serum vitamin B12 levels below the cut-off value of 570 ng/L and IFNL3/IFNL4 rs12979860 CC genotype achieved a SVR rate of even 80% with an OR of 54 (CI 9.9-293, p < 0.0001) compared to patients above the cut-off value and non-CC-genotypes.CONCLUSION: Our data suggest baseline serum vitamin B12 levels as useful noninvasive marker for characterizing CHC patients. They might further help to identify responders to a standard treatment.