In HIV/hepatitis C virus co-infected patients, higher 25-hydroxyvitamin D concentrations were not related to hepatitis C virus treatment responses but were associated with ritonavir use.

TitleIn HIV/hepatitis C virus co-infected patients, higher 25-hydroxyvitamin D concentrations were not related to hepatitis C virus treatment responses but were associated with ritonavir use.
Publication TypeJournal Article
Year of Publication2013
AuthorsBranch AD, Kang M, Hollabaugh K, Wyatt CM, Chung RT, Glesby MJ
JournalAm J Clin Nutr
Volume98
Issue2
Pagination423-9
Date Published2013 Aug
ISSN1938-3207
KeywordsAdult, Antiviral Agents, Coinfection, Drug Therapy, Combination, Female, Genotype, Hepacivirus, Hepatitis C, HIV, HIV Infections, Humans, Interferon-alpha, Logistic Models, Male, Middle Aged, Retrospective Studies, Ribavirin, Ritonavir, RNA, Viral, Viral Load, Vitamin D
Abstract

BACKGROUND: Among patients with hepatitis C virus (HCV) monoinfection, 25-hydroxyvitamin D [25(OH)D] concentrations are positively associated with a response to peg-interferon/ribavirin. Data on the relation between 25(OH)D concentrations and HCV treatment response in HIV-infected patients are limited.

OBJECTIVE: The objective was to determine whether baseline 25(OH)D concentrations predict virologic response in HIV/HCV co-infected patients and to examine variables associated with 25(OH)D concentrations ≥30 ng/mL.

DESIGN: Data and samples from 144 HCV genotype 1, treatment-naive patients from a completed HCV treatment trial were examined in this retrospective study. Early virologic response (EVR) was defined as ≥2 log10 reduction in HCV RNA and/or HCV RNA <600 IU/mL at week 12 of peg-interferon/ribavirin treatment. Baseline 25(OH)D was measured by liquid chromatography/tandem mass spectrometry.

RESULTS: Compared with the non-EVR control group (n = 68), the EVR group (n = 76) was younger, had fewer cirrhotic subjects, had a higher proportion with the IL28B CC genotype, had a higher albumin concentration, and had a lower HCV viral load at baseline (P ≤ 0.05). The difference in baseline 25(OH)D concentrations between EVR and non-EVR patients was not statistically significant (median: 25 ng/mL compared with 20 ng/mL; P = 0.23). Similar results were found for sustained virologic response (SVR). In multivariable analysis, white and Hispanic race-ethnicity (OR: 6.26; 95% CI: 2.47, 15.88; P = 0.0001) and ritonavir use (OR: 2.68; 95% CI: 1.08, 6.65; P = 0.033) were associated with higher 25(OH)D concentrations (≥30 ng/mL).

CONCLUSION: Baseline 25(OH)D concentrations did not predict EVR or SVR. Because ritonavir impairs the conversion of 25(OH)D to the active metabolite, utilization of 25(OH)D may have been impaired in subjects taking ritonavir. This trial was registered at www.clinicaltrials.gov as NCT00078403.

DOI10.3945/ajcn.112.048785
Alternate JournalAm. J. Clin. Nutr.
PubMed ID23739141
PubMed Central IDPMC3712551
Grant ListDA031095 / DA / NIDA NIH HHS / United States
DK090317 / DK / NIDDK NIH HHS / United States
K24 AI78884 / AI / NIAID NIH HHS / United States
R01 DA031095 / DA / NIDA NIH HHS / United States
R01 DK090317 / DK / NIDDK NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01AI068634 / AI / NIAID NIH HHS / United States
U01AI068636 / AI / NIAID NIH HHS / United States
UL1 TR000457 / TR / NCATS NIH HHS / United States
UM1 AI069412 / AI / NIAID NIH HHS / United States
UM1 AI069419 / AI / NIAID NIH HHS / United States