Evaluation of vitamin d levels in chronic hepatitis b patients

ABSTRACT Introduction and objective: Hepatitis B virus (HBV) infection continues to be among the prominent healthcare problems around the world. The liver is a critical organ for the storage and metabolism of vitamin D. Vitamin D is known to play a role in various biological processes including cell differentiation, cell proliferation and inhibition of immune modulation. Recently, vitamin D levels are thought to influence the immune system and the host response in viral infections such as HBV infections. In this study, our aim is to compare the vitamin D levels in healthy individuals and those with HBV infection in order to observe the relationship between the vitamin D levels and the HBV replication and disease progression. Material and Method: From amongst the patients who presented to the Dicle University Medical Faculty Hospital, Department of Infectious Diseases and Clinical Microbiology between January 2014 and December 2015, 29 HBsAg-positive and HBV DNA negative individuals, 30 HBsAg-positive individuals with HBV DNA of 2000-20000 IU/ml, 31 HBsAg-positive individuals with HBV DNA >20000 IU/ml and 45 HBsAg-negative individuals (control group) without comorbidities, who presented to our clinic with asthenia and fatigue and were tested for vitamin-D levels were evaluated in our study. The subjects' 25 (OH) D levels were tested at the baseline, 6th month and 12th month. Results: Among the patients, 77 (57%) were male and 58 (43%) were female. The patients' mean age was 40.8 and there was no statistically significant difference in terms of age and gender between the groups. No significant difference was observed between males and females regarding the baseline, 6-month and 12-month vitamin D levels (p=0.133, p=0.319, p=0.212, respectively). The mean vitamin D levels among the patients with chronic hepatitis B (CHB) was 23.37±10.71 µg/l, while the mean vitamin D levels in the control group was 35.54±10.42 µg/l (p<0.001). Thus, the insufficient vitamin D levels among the patients with CHB were lower than the levels tested in the control group. The vitamin D levels in the control group were within the normal range. The intra-group comparison of the vitamin D levels among the CHB patients did not point to a significant difference. No significant association between lower vitamin D levels and higher viral load were observed in this study. Conclusion: The vitamin D levels in patients with CHB were found to be insufficient. Although lower vitamin D levels were observed to be unassociated with high viral load in this study, there is still a need for prospective and controlled studies with more detailed design. Also, the patients need to be followed up in terms of vitamin D insufficiency and replacement therapy. Keywords: Chronic hepatitis B, vitamin D, viral load, liver