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Hepatitis-C treatment greatly enhanced with 2000 IU of Vitamin D – RCT Dec 2011


Hepatitis-C reduced 30% by Vitamin D (any amount) – meta-analysis Aug 2017

Efficacy of vitamin D supplementation in combination with conventional antiviral therapy in patients with chronic hepatitis C infection: a meta-analysis of randomised controlled trials.
J Hum Nutr Diet. 2017 Aug 18. doi: 10.1111/jhn.12503. [Epub ahead of print]
Kim HB1,2, Myung SK3,4,5, Lee YJ2,6, Park BJ2,7.

Only rarely do meta-analyses consider dose sizes or durations used in random controlled trials
Study was reviewed at Vitamin C Council

# of RCTs
using Dose
IU Dose size
1 1,000 IU
11,600 IU
4 2,000 IU
1 2,140 IU
(15,000/week)

BACKGROUND:
Although a contributory role of vitamin D levels for the development of chronic hepatitis C has been suggested, the efficacy of vitamin D supplementation in combination with conventional antiviral therapy consisting of pegylated interferon-α (Peg-IFN-α) injection and oral ribavirin (RBV) remains unclear. We investigated its efficacy in the treatment of chronic hepatitis C via a meta-analysis of randomised controlled trials.
METHODS:
We searched PubMed, EMBASE, the Cochrane Library, ClinicalTrials.gov and the bibliographies of relevant articles to locate additional publications in September 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria.
RESULTS:
Of 522 articles meeting our initial criteria, a total of seven open-label, randomised controlled trials involving 548 participants, were included in the final analysis. Vitamin D supplementation in combination with Peg-IFN-α injection and oral RBV significantly increased the rate of viral response for hepatitis C at 24 weeks after treatment in a random-effects meta-analysis (relative risk = 1.30; 95% confidence interval = 1.04-1.62; I2 = 75.9%). Also, its significant efficacy was observed in patients with hepatitis C virus genotype 1, which is known to be refractory to antiviral therapy.
CONCLUSIONS:
In summary, we observed that additional use of vitamin D has a positive effect on sustained viral response rates of patients with chronic hepatitis C infection. However, we cannot establish the efficacy because of substantial heterogeneity, a small sample size and a low methodological quality.

PMID: 28833855 DOI: 10.1111/jhn.12503    Publisher rents PDF for $6


Update May 2016 on the virus which affects the liver

  • Hepatitis C-related deaths hit record high in U.S., CDC says Washington Post May 2016
    "more Americans die now as a result of hepatitis C infection than from 60 other infectious diseases combined"
    "About 3.5 million Americans have chronic hepatitis C infection . . . "
    "But at least half of those infected don't know it and have not been tested"
    " . . . drugs can be as much as $1,000 a day . . . "

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Wikipedia chart

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Hepatitis-C treatment greatly enhanced with 2000 IU of Vitamin D – RCT Dec 2011

Vitamin D supplementation improves sustained virologic response in chronic hepatitis C (genotype 1)-naïve patients.- 2011
World J Gastroenterol. 2011 Dec 21;17(47):5184-90. doi: 10.3748/wjg.v17.i47.5184.
Abu-Mouch S1, Fireman Z, Jarchovsky J, Zeina AR, Assy N.

AIM:
To determine whether adding vitamin D, a potent immunomodulator, improves the hepatitis C virus (HCV) response to antiviral therapy.
METHODS:
Seventy-two consecutive patients with chronic HCV genotype 1 were randomized into two groups: the treatment group (n = 36, 50% male, mean age 47 ± 11 years) received Peg-α-2b interferon (1.5 μg/kg per week) plus ribavirin (1000-1200 mg/d) together with vitamin D3 (2000 IU/d, target serum level > 32 ng/mL), and the control group (n = 36, 60% male, mean age 49 ± 7 years) received identical therapy without vitamin D. HCV-RNA was assessed by real-time polymerase chain reaction (sensitivity, 10 IU/mL). The sustained virologic response (SVR) was defined as undetectable HCV-RNA at 24 wk post-treatment.
RESULTS:
Clinical characteristics were similar in both groups. The treatment group had a higher mean body mass index (27 ± 4 kg/m² vs 24 ± 3 kg/m²; P < 0.01), viral load (50% vs 42%, P < 0.01), and fibrosis score (> F2: 42% vs 19%, P < 0.001) than the controls. At week 4, 16 (44%) treated patients and 6 (17%) controls were HCV-RNA negative (P < 0.001). At week 12, 34 (94%) treated patients and 17 (48%) controls were HCV-RNA negative (P < 0.001). At 24 wk post-treatment (SVR), 31 (86%) treated patients and 15 (42%) controls were HCV-RNA negative (P < 0.001). Viral load, advanced fibrosis and vitamin D supplementation were strongly and independently associated with SVR (multivariate analysis). Adverse events were mild and typical of Peg-α-2b/ribavirin.
CONCLUSION:
Adding vitamin D to conventional Peg-α-2b/ribavirin therapy for treatment-naïve patients with chronic HCV genotype 1 infection significantly improves the viral response.

PMID: 22215943
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Evidence supporting a beneficial role of vitamin D in chronic hepatitis C. - March 2015

Letter to Editor
J Hepatol. 2015 Apr 20. pii: S0168-8278(15)00292-5. doi: 10.1016/j.jhep.2015.03.037. [Epub ahead of print]
Pang Q1, Qu K1, Zhang JY1, Liu C2.
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China.
2Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China. Electronic address: liuchangdoctor at 163.com.
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The Interplay between Zinc, Vitamin D and, IL-17 in Patients with Chronic Hepatitis C Liver Disease - 2015

J Immunol Res. 2015;2015:846348. doi: 10.1155/2015/846348. Epub 2015 Oct 4.
Reda R1, Abbas AA1, Mohammed M1, El Fedawy SF1, Ghareeb H1, El Kabarity RH1, Abo-Shady RA1, Zakaria D2.

OBJECTIVES:
To assess zinc (Zn) and vitamin D (Vit. D) status in chronic Hepatitis C virus- (HCV) infected patients and their relationship to interleukin- (IL-) 17 and disease severity and then investigate whether Zn and Vit. D3 modulate IL-17 expression in chronic HCV patients.
METHODS:
Seventy patients and fifty healthy subjects were investigated. Serum levels of Zn, Vit. D, and IL-17 were assessed in the patients group and subgroups. Patients lymphocytes were activated in vitro in the presence or absence of Zn or Vit. D3 and then intracellular IL-17 production was assessed using flow cytometry.
RESULTS:
Zn and Vit. D were significantly decreased in HCV patients. Increasing disease severity leads to more reduction in Zn level opposed by increasing IL-17 level. Zn potently reduced IL-17 production in a dose-related fashion; however it did not exert any toxic effects. Although Vit. D apparently increases IL17 expression, it is unclear whether it is due to its toxic effect on cell count or lack of definite association between Vit. D and both IL-17 and disease severity.
CONCLUSIONS:
This study demonstrates that Zn modulates IL-17 expression and provides a rationale for evaluating this compound as a supplementary agent in the treatment of chronic HCV.

PMID: 26504859 PMCID: PMC4609465 DOI: 10.1155/2015/846348

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Vitamin D status and viral response to therapy in hepatitis C infected children - 2015

World J Gastroenterol. 2015 Jan 28;21(4):1284-91. doi: 10.3748/wjg.v21.i4.1284.
Eltayeb AA1, Abdou MA1, Abdel-aal AM1, Othman MH1.

AIM:
To study the frequency of vitamin D deficiency in patients with hepatitis C virus (HCV) infection and to evaluate the role of vitamin D supplementation in improving antiviral therapy.
METHODS:
Sixty-six children aged from 7-14 years (mean ± SD, 11.17±2.293) diagnosed with HCV infection were matched to 28 healthy controls. Serum levels of 25 (OH) D3, calcium, phosphorus, alkaline phosphatase and plasma level of parathormone were measured. Quantitative PCR for HCV was performed Bone density was determined by dual energy X-ray absorptiometry. All cases received conventional therapy, and only 33 patients received vitamin D supplementation.
RESULTS:
Children with HCV showed significantly increased levels of HCV RNA (P<0.001), parathormone (P<0.01) and decreased vitamin D levels (P<0.05) (33.3% deficient and 43.3% insufficient) compared with controls. Abnormal bone status (Z score -1.98±0.75) was found in ribs, L-spine, pelvis and total body. Cases treated with vitamin D showed significant higher early (P<0.04) and sustained (P<0.05) virological response. There was a high frequency of vitamin D deficiency among the Egyptian HCV children, with significant decrease in bone density. The vitamin D level should be assessed before the start of antiviral treatment with the correction of any detected deficiency.
CONCLUSION:
Adding vitamin D to conventional Peg/RBV therapy significantly improved the virological response and helped to prevent the risk of emerging bone fragility.

PMID: 25632203 PMCID: PMC4306174 DOI: 10.3748/wjg.v21.i4.1284
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Reduced Hepatitis C response in those with higher levels of vitamin D - Aug 2014

Serum 25(OH)D3 levels affect treatment outcomes for telaprevir/peg-interferon/ribavirin combination therapy in genotype 1b chronic hepatitis C.
Dig Liver Dis. 2014 Aug;46(8):738-43. doi: 10.1016/j.dld.2014.05.004. Epub 2014 May 29.
Atsukawa M1, Tsubota A2, Shimada N3, Abe H4, Kondo C5, Itokawa N5, Nakagawa A5, Iwakiri K5, Kawamoto C6, Aizawa Y4, Sakamoto C6.

BACKGROUND:
Close relationships between chronic hepatitis C and vitamin D levels have been reported. For genotype 1b infection, the current standard of care is pegylated interferon/ribavirin therapy combined with a protease inhibitor. The present study analyzed the relationship between outcomes of triple therapy and serum 25(OH)D3 levels.
METHODS:
Factors contributing to sustained virological response were investigated in 177 patients with chronic hepatitis C who received telaprevir-based triple therapy in this prospective study.
RESULTS:
The sustained virological response rate was 86.9% in patients with 25(OH)D3 levels of >18 ng/ml; this was higher than the 66.7% in patients with 25(OH)D3 levels of ≤ 18 ng/ml (P=0.003). 25(OH)D3 levels and IL28B genotype were identified as significantly independent factors contributing to sustained virological response. The sustained virological response rate did not differ according to 25(OH)D3 levels in patients with the IL28B major genotype. The sustained virological response rate was 64.9% in patients with the IL28B minor genotype and 25(OH)D3 levels of >18 ng/ml, and was 38.5% in those with decreased 25(OH)D3 levels (P=0.045).
CONCLUSIONS:
In triple therapy, 25(OH)D3 levels were an independent factor contributing to sustained virological response. Of particular note, the sustained virological response rate was significantly lower in patients with the IL28B minor genotype.

PMID: 24880716 DOI: 10.1016/j.dld.2014.05.004

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Attached files

ID Name Comment Uploaded Size Downloads
7133 HCV 2015.pdf PDF 2015 admin 02 Oct, 2016 11:04 1,013.40 Kb 266
7132 Zinc, Vitamin D and, IL-17 Hepatitis C.pdf PDF 2015 admin 02 Oct, 2016 10:55 1.83 Mb 269
6956 HVC Gale.jpg admin 08 Aug, 2016 11:31 23.31 Kb 620
6640 Hepatitis wikipedia.jpg admin 04 May, 2016 20:49 33.72 Kb 906
6639 Hepatitis CDC.jpg admin 04 May, 2016 20:48 20.74 Kb 983
5374 Chronic hepatitis c.pdf PDF 2015 admin 27 Apr, 2015 01:30 273.01 Kb 776
4987 HCV Jan 2015.pdf PDF 2015 admin 30 Jan, 2015 12:41 1,013.40 Kb 835
4622 Hepatitis C Korea 2011.pdf PDF admin 24 Nov, 2014 02:23 225.59 Kb 750
4621 hepatitis C Meta-analysis Sept 2013.pdf PDF admin 24 Nov, 2014 02:22 1.12 Mb 772
4373 Hepatitis2.jpg admin 17 Sep, 2014 01:00 66.46 Kb 1850
4372 Hepatitis1.jpg admin 17 Sep, 2014 00:59 48.74 Kb 1886
4371 Hepatitis-C.pdf PDF admin 17 Sep, 2014 00:48 801.40 Kb 1005
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