Published online Jun 27, 2013. doi: 10.4254/wjh.v5.i6.328
Revised: May 16, 2013
Accepted: May 18, 2013
Published online: June 27, 2013
AIM: To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
METHODS: Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
RESULTS: Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA < 100 IU/mL) OR = 3 (95%CI: 2.6-4.2, P = 0.01) and duration of HBsAg seropositivity (> 8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
CONCLUSION: We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
Core tip: Vitamin D has recently been linked to many autoimmune diseases. Hepatitis B is a viral disease but shows many autoimmune characteristics. Spontaneous hepatitis B seroclearance is an unexplained phenomenon. The hypothesis of this paper was that normal vitamin D levels may be linked to a positive effect on hepatitis B. We showed that normal vitamin D levels correlate positively with spontaneous hepatitis B seroclearance. This finding may help to expand the therapeutic options for this disease.