Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Low 25-OH Vitamin D Serum Levels Correlate with Extra-Hepatic Manifestations in Chronic Hepatitis C Virus Infection.

Terrier2,  Benjamin, Souberbielle1,  Jean-Claude, Saadoun3,  David, Geri3,  Guillaume, Schoindre3,  Yoland, Sene3,  Damien, Musset3,  Lucile

Necker
Pitié-Salpéterière, Paris, France
Pitié-Salpéterière
Pitié-Salpétrière

Background:

Recent studies have suggested the critical role of vitamin D in the regulation of the immune system, in promoting the development of regulatory T cells and decreasing pro-inflammatory cytokines and B cell differentiation. Correlation between low levels of 25-OH vitamin D and disease activity have been reported in various autoimmune disorders. The beneficial role of vitamin D administration was also suggested in chronic HCV infection.

Objective:

To evaluate the association between serum 25-OH vitamin D levels and the presence of extra-hepatic manifestations and immunological abnormalities during chronic HCV infection.

Patients and Methods:

Ninety-four HCV+ RNA+ untreated patients [36 without mixed cryoglobulinemia (MC), 10 with asymptomatic MC and 48 with MC-vasculitis) were included. Clinical and biological characteristics were recorded and compared according to vitamin D status. Vitamin D status was classified as: deficiency if serum 25-OH vitamin D level < 12, insufficiency between 12 and 30, and sufficiency > 30 ng/ml. Kruskal-Wallis test was used to compare groups. Correlations between serum 25-OH vitamin D levels and biological and immunological features were analyzed using nonparametric Spearman correlation.

Results:

Overall, 84 (89%) patients had hypovitaminosis D (< 30 ng/ml). Patients were distinguished according to vitamin D status: sufficiency (n=10), insufficiency (n=52), and deficiency (n=32). Demographical and HCV infection characteristics were similar between groups. Patients with vitamin D deficiency vs. insufficiency vs. sufficiency had more frequently: vasculitis (75 vs. 42 vs. 20%; P=0.002), arthralgia (50 vs. 31 vs. 20%; P=0.11), neuropathy (59 vs. 38 vs. 20%; P=0.048), purpura (63 vs. 35 vs. 10%, P=0.004), and renal involvement (28 vs. 12 vs. 10%, P=0.11). Biologically, patients with vitamin D deficiency vs. insufficiency vs. sufficiency had more frequently type II MC (77 vs. 46 vs. 10%; P=0.002) and low C4 serum levels (86 vs. 47 vs. 0%; P<0.0001). A negative correlation was found between 25-OH vitamin D and C4 serum levels (r2=0.20; P=0.001) and the level of marginal zone B cells (r2=0.24; P=0.001), and a positive correlation with regulatory T cells (r2=0.23; P=0.005).

Conclusion:

In chronic HCV infection, low 25-OH vitamin D serum levels correlate with clinical and biological immune extra-hepatic manifestations. These findings suggest the potential benefit of vitamin D supplementation in HCV infected patients with extra-hepatic manifestations.

To cite this abstract, please use the following information:
Terrier, Benjamin, Souberbielle, Jean-Claude, Saadoun, David, Geri, Guillaume, Schoindre, Yoland, Sene, Damien, et al; Low 25-OH Vitamin D Serum Levels Correlate with Extra-Hepatic Manifestations in Chronic Hepatitis C Virus Infection. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2030
DOI: 10.1002/art.29795

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