Researchers from Germany have found that low levels of vitamin D are
associated with high levels of hepatitis B virus (HBV) replication.
Findings published online in Hepatology,
a journal of the American Association for the Study of Liver Diseases,
suggest seasonal fluctuations in vitamin D and HBV levels point to a
link in these variables among patients with chronic HBV.
While highly effective vaccines are available, HBV
still remains one of the most significant infectious diseases worldwide.
In fact, the World Health Organization (WHO) states that HBV is 50 to
100 times more infectious than human immunodeficiency virus (HIV).
Furthermore WHO reports that two billion individuals have been infected
with HBV, which is responsible for nearly 600,000 deaths each year. In
the U.S. the Centers for Disease Control and Prevention (CDC) estimates
that up to 1.4 million Americans are living with chronic HBV.
“Vitamin D helps maintain a healthy immune
system and there is evidence of its role in inflammatory and metabolic
liver disease, including infection with hepatitis C virus (HCV),”
explains lead investigator Dr. Christian Lange from Johann Wolfgang
Goethe University Hospital in Frankfurt. “However, the relationship
between vitamin D metabolism and chronic HBV infection remains unknown
and is the focus of our present study.”
Between January 2009 and December 2010, the
team recruited 203 patients with chronic HBV who had not previously
received treatment for their infection. Levels of 25-hydroxyvitamin D
were measured from each participant. Patients co-infected with HCV, HIV,
or hepatitis D; those with excessive alcohol use; and those with liver
cancer or other malignancies were excluded.
Results show that 34% of participants had
severe vitamin D deficiency (less than 10 ng/mL), 47% with vitamin D
insufficiency (between 10-20 ng/mL) and 19% had normal levels of vitamin
D (greater than 20 ng/mL). Further analyses indicate that the
concentration of HBV in the blood, known as viral load, was a strong
indicator of low vitamin D levels. In patients with HBV DNA less than
2000 IU/mL versus 2000 IU/mL or more, the levels of vitamin D were 17
and 11 ng/mL, respectively.
Researchers also determined that patients with the
hepatitis B antigen (HBeAg) had lower levels of vitamin D than HBeAg
negative participants. Inverse seasonal fluctuations between vitamin D
and HBV levels were noted, which further suggests a relationship between
the two variables.
“Our data confirm an association between low levels of
vitamin D and high concentrations of HBV in the blood,” concludes Dr.
Lange. “These findings differ from previous research of patients with
chronic hepatitis C, which found no connection between vitamin D levels
and concentration of HCV in the blood.” The authors propose further
investigation of vitamin D as a therapeutic intervention for controlling
Full citation: “Low Vitamin D Serum
Concentration is Associated with High Levels of Hepatitis B Virus (HBV)
Replication in Chronically Infected Patients.” Harald Farnik, Jorg
Bojunga, Annemarie Berger, Regina Allwinn, Oliver Waidmann, Bernd
Kronenberger, Oliver T. Keppler, Stefan Zeuzem, Christoph Sarrazin and
Christian M. Lange. Hepatology; (DOI: 10.1002/hep.26488) Published Online: May 22, 2013.
Source: Wiley http://www.wiley.com.
Labels: Disease Management, HBV, Vitamin D