Effect of vitamin D supplementation on pegylated interferon/ribavirin therapy for chronic hepatitis C genotype 1b: a randomized controlled trial.

Chronic HCV-infected patients tend to have vitamin D deficiency, suggesting that vitamin D supplementation may enhance the efficacy of treatment with pegylated interferon (PEG-IFN) and ribavirin (RBV). We therefore assessed the effects of vitamin D supplementation on viral response to PEG-IFN/RBV. Eighty-four patients with HCV genotype 1b were randomized, 42 to oral vitamin D supplementation (1000 IU/day) and 42 to nonsupplementation (control), from week 8 to the end of PEG-IFN/RBV therapy. The primary end point was undetectable HCV RNA at week 24 (viral response [VR]). VR rate at week 24 was significantly higher in the vitamin D than in the control group (78.6% vs 54.8% P = 0.037). Adverse events were similar in both groups. When patients were subdivided by IL28B SNP rs8099917 genotype, those with the TT genotype group showed a significantly higher VR rate at week 24 with than without vitamin D supplementation (86.2% vs 63.3% vs P = 0.044). Although patients with the TG/GG genotype, who were relatively resistant to PEG-IFN treatment, had similar VR rates at week 24 with and without vitamin D supplementation, the decline in viral load from week 8 to week 24 was significantly greater with than without vitamin D supplementation. Multivariate analysis showed that rs8099917 genotype and vitamin D supplementation contributed significantly to VR at week 24. SVR rates were similar in the vitamin D and control groups [64.3% (27/42) vs 50% (21/42), P = 0.19]. Vitamin D supplementation may enhance the effects of PEG-IFN/RBV in HCV genotype 1b-infected patients.

[Cardiovascular complications of interferon therapy in chronic hepatitis C].

Severe cardiovascular complications (myocardial infarction, ventricular fibrillation et al.) have been reported in patients who have been administrated extremely high dose interferon (IFN) or cardio-toxic drugs, or who have had cardiovascular diseases. But cardiomyopathy, myocarditis and atrioventricular block were reported in patients who administered low dose IFN and no cardio-toxic drugs or had no cardiovascular diseases. We report here cardiovascular complications during IFN therapy for chronic hepatitis C. Cardiovascular complications that necessitated stopping IFN administration in 643 treated chronic hepatitis C patients are observed in 4 patients (0.62%). Second-degree atrioventricular block occurred in two patients, myocarditis in one patient and severe sinus bradycardia in one patient. So we have to check risk factors of cardiovascular complications before starting IFN therapy and electrocardiogram during IFN therapy.