BASELINE SERUM HDL AND VITAMIN D LEVELS ARE STRONGLY ASSOCIATED WITH SVR IN CHRONIC HEPATITIS C NAïVE GENOTYPE-1 PATIENTS

EASL Session Title: Category 08b: Viral Hepatitis C: Clinical (except therapy)


Presentation Date: 02 APR, 2011

BASELINE SERUM HDL AND VITAMIN D LEVELS ARE STRONGLY ASSOCIATED WITH SVR IN CHRONIC HEPATITIS C NAïVE GENOTYPE-1 PATIENTS

W. Nseir1, M. Gali2, S. Abu Mouch3, A. Djibre4, F. Nassar5, N. Assy4,6*

1Holy Family Hospital, 2Internal Medicine, Holy Family Hospital, Nazareth, 3Liver Unit, Hillel Yafe Medical Center, Hillel Yafe, 4Liver Unit, Ziv Medical Center, Safed, 5Internal Medicine, Western Galilee Hospital, Nahariya, 6Technion Institute, Haifa, Israel. *assy.n@ziv.health.gov.il

Background: HCV cell entry is a multi-step process, involving several viral and cellular factors that trigger virus uptake into the hepatocyte. Hepatic LDL receptor and vitamin D receptors are closely related to HCV infection.

Aim: To assess the association between serum lipoproteins and vitamin D levels and sustained viral response (SVR).

Methods: 80 chronic HCV genotype 1 naïve patients (age 47±15 yrs; 43 men, BMI 28±3) received peg interferon alpha-2a (sc 180 µg once weekly) or peg interferon alpha 2b (1.5µg/kg) plus ribavirin 1200 mg/d during 48 weeks. Lipid profile and vitamin D levels were measured.

HCV RNA was assessed by RT-PCR and undetectable HCV RNA at week 24 post treatment was considered as SVR. Patients were divided into two groups (responders Vs non responders according to SVR).

Results: The patients population had a high BMI (28±2), high viral load (>400,000 IU/l) and high fibrosis score (Metavir scores >F2) in 50%, 40%, and 30% respectively.

Overall, 42 % of patients were responders. Responders had significantly lower serum cholesterol levels (152±43 Vs 181±33 mg%, P=0.01), lower LDL levels (83±31 Vs 104±29, mg%, P=0.008), lower HDL levels (42±14 Vs 50±10, mg%, P=0.009), and higher vitamin D levels (42.1±6.0 Vs 27.3±5.2 ng/ml, P< 0.001) than non responders. Triglycerides levels were similar in both groups (179±30 Vs 183±40, mg%, P>0.05). Multivariate logistic regression analysis showed that gender (Women, OR 2.3, P< 0.001), low cholesterol levels (< >180mg/dL; OR 2.5, P< 0.03), low HDL (< >40 mg/dL, OR 3.5, P< 0.001), and high vitamin D levels (< > 20 ng/ml, OR 3.8, P< 0.001) are strongly associated with SVR.

Conclusions: Low HDL serum level and high vitamin D serum levels are strongly associated with sustained viral response in chronic HCV naïve genotype- 1 patients.

http://www1.easl.eu/easl2011/program/Posters/Abstract1016.htm