Vitamin D-Parathyroid Hormone Paradox in Patients with Chronic Hepatitis C

Background & Aims: Studies correlating 25(OH)D-parathyroid hormone (PTH) status and severity of the various chronic liver injuries reported conflicting results. Our aim was to determine the prevalence and type of vitamin D-PTH disturbance in a homogeneous cohort of patients with non-cirrhotic chronic hepatitis C (CHC) and its relationship with disease severity.Methods: We studied 66 outpatients (28 men; mean age, 52.7+/-13.7 [SD] y) with non-cirrhotic CHC. Serum concentrations of 25(OH)D, PTH, and biochemistries were determined. Results:Serum 25(OH)D levels were inadequate in 25 patients: deficiency (0-10 ng/mL) in 3 patients and insufficiency (11-20 ng/mL) in 22 patients. Fifteen patients had inadequate PTH levels (reference 10-69 pg/ml). The severity of CHC according to HALT-C formula showed absent correlation with the serum 25(OH)D concentration. The percentages of subjects with hypovitaminosis D (0-20 ng/mL) were as follows: HALT-C less than 0.2, 58.8%; HALT-C 0.2-0.5, 30.6%; and in HALT-C more than 0.5, 30.8%. There was no correlation between vitamin D and serum levels of PTH, calcium, phosphate, aminotransferases, ALP, urea, creatinine, and albuminConclusions: Vitamin D inadequacy exists in non-cirrhotic CHC but does not correlate with disease severity. Inadequate PTH levels occur in CHC but the explanation remains ill-defined. Future trial should evaluate the economic efficacy of vitamin D supplementation in CHC and the impact of low PTH levels on virologic response rates during and after treatment.