维生素D缺乏和肝炎病毒相关的肝脏疾病：文献综述。

StephenW

World J Gastroenterol. 2018 Jan 28;24(4):445-460. doi: 10.3748/wjg.v24.i4.445.
Vitamin D deficiency and hepatitis viruses-associated liver diseases: A literature review.
Hoan NX1, Tong HV2, Song LH1, Meyer CG3, Velavan TP4.
Author information
Abstract

The secosteroid hormone vitamin D has, in addition to its effects in bone metabolism also functions in the modulation of immune responses against infectious agents and in inhibiting tumorigenesis. Thus, deficiency of vitamin D is associated with several malignancies, but also with a plethora of infectious diseases. Among other communicable diseases, vitamin D deficiency is involved in the pathogenesis of chronic liver diseases caused by hepatitis B and C viruses (HBV, HCV) and high prevalence of vitamin D deficiency with serum levels below 20 mg/mL in patients with HBV and HCV infection are found worldwide. Several studies have assessed the effects of vitamin D supplementation on the sustained virological response (SVR) to interferon (IFN) plus ribavirin (RBV) therapy in HBV and HCV infection. In these studies, inconsistent results were reported. This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBV- and HCV-related chronic liver diseases. Furthermore, current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.
KEYWORDS:

Chronic liver disease; Hepatitis B virus infection; Hepatitis C virus infection; Hepatocellular carcinoma; Liver cirrhosis; Sustained virological response; Vitamin D; Vitamin D deficiency; Vitamin D supplementation

StephenW

世界J Gastroenterol。 2018年1月28日; 24（4）：445-460。 doi：10.3748 / wjg.v24.i4.445。
维生素D缺乏和肝炎病毒相关的肝脏疾病：文献综述。
Hoan NX1，Tong HV2，Song LH1，Meyer CG3，Velavan TP4。
作者信息
抽象

除了其在骨代谢中的作用之外，所述类固醇激素维生素D还具有调节针对感染因子的免疫应答和抑制肿瘤发生的功能。因此，维生素D的缺乏与几种恶性肿瘤有关，而且还有许多传染性疾病。在其他传染病中，维生素D缺乏症与乙型肝炎病毒和丙型肝炎病毒（HBV，HCV）引起的慢性肝病的发病有关，HBV和HCV患者血清维生素D缺乏率低于20mg / mL世界各地都有感染。几项研究评估了补充维生素D对持续病毒学应答（SVR）对干扰素（IFN）联合利巴韦林（RBV）治疗HBV和HCV感染的影响。在这些研究中，报告了不一致的结果。本综述介绍了维生素D缺乏症的一般情况，特别是维生素D维生素D缺乏在HBV和HCV相关慢性肝病结局中的意义。此外，目前的文献进行了审查，以了解补充维生素D与基于干扰素的治疗对HBV和HCV感染患者病毒学应答的影响。
关键词：

慢性肝病;乙型肝炎病毒感染;丙型肝炎病毒感染;肝细胞癌;肝硬化;持续的病毒学反应;维生素D;维生素D缺乏症;维生素D的补充

StephenW

Vitamin D deficiency is very common and frequently observed in HBV- and HCV-associated chronic liver diseases. It negatively affects the clinical courses and promotes progression of liver diseases, but causal relations are still not fully understood. Several lines support that sufficient vitamin D levels play an important role during antiviral treatment of HBV and HCV infections. However, the effect of vitamin D supplementation in combination with IFN-RBV based therapy on virological responses is still unclear. Various non-skeletal effects of vitamin D, including antiinflammatory, antifibrotic and antitumor properties have emphasized an association of vitamin D deficiency with unfavorable liver disease outcomes, in particular, liver cirrhosis. There is currently no approved recommendation for vitamin D supplementation and vitamin D analogues as supportive adjuvant treatment regimes in viral hepatitis and related chronic disorders. Further randomized, placebo-armed studies need to be performed in order to confirm whether supplementation of vitamin D or vitamin D analogues improve SVRs in combination with specific antiviral treatment strategies in HBV or HCV infections.
维生素D缺乏症在HBV和HCV相关的慢性肝病中很常见。它对临床病程有负面影响，促进肝脏疾病的进展，但因果关系尚不完全清楚。有几条线支持在抗病毒治疗HBV和HCV感染期间足够的维生素D水平发挥重要作用。然而，补充维生素D与基于IFN-RBV治疗病毒学应答的效果尚不清楚。维生素D的各种非骨骼效应，包括抗炎，抗纤维化和抗肿瘤特性，都强调了维生素D缺乏与不利的肝病结果，特别是肝硬化的关联。目前还没有批准维生素D补充剂和维生素D类似物作为病毒性肝炎和相关慢性疾病的辅助治疗方案。进一步的随机，安慰剂的武装研究需要进行，以确认是否补充维生素D或维生素D类似物改善SVR结合特定的抗病毒治疗策略在HBV或HCV感染。