Effect of season and sunlight on viral kinetics during hepatitis C virus therapy.

Fecha de publicación: 01/07/2017

Autores de IIS La Fe

• María García Eliz

  Autor

Participantes ajenos a IIS La Fe

• Hernandez-Alvarez, N
• Acevedo, JMP
• Quintero, E
• Vazquez, IF
• Negro, JD
• Garcia, JC
• Hernandez-Guerra, M

Grupos

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

  

  Leader

  Marina Berenguer Haym

Abstract

BACKGROUND AND AIMS: Rapid viral response (RVR) during antiviral treatment for hepatitis C virus (HCV) predicts sustained viral response (SVR). Recently, vitamin D levels have been associated with SVR. As sunlight is the most important source of vitamin D and shows seasonal variation, we evaluated the effect of season on viral kinetics during peginterferon/ribavirin-based therapy for HCV. METHODS: Consecutive HCV patients treated with peginterferon/ribavirin and boceprevir/ telaprevir (June 2011-July 2014) were included. Patients were grouped according to season when therapy was initiated (Season A: May-October and Season B: November-April) depending on hours of daily sunlight. Multiple logistic regression analysis included factors known to influence SVR to treatment. The dependent variables were undetectable viral load (VL) or VL </=15 UI/mL (VL </=15) at weeks 4, 8 and 12, end of treatment and SVR. RESULTS: The study included 930 patients (66.8% men; median 54 years) treated with telaprevir (n=537) or boceprevir, without (n=481) or with lead-in therapy of peginterferon/ribavirin. Baseline characteristics of patients in Season A (45.3%, n=421) and Season B groups were similar. Overall, a higher rate of RVR (23.5% vs 16.1%, p=0.005) and VL </=15 (51.0% vs 38.6%, p</=0.001) was observed in patients starting treatment during Season A versus Season B. By logistic regression analysis, initiating treatment in Season A proved to be an independent predictor of RVR and VL </=15. CONCLUSIONS: In our setting, seasonality affects viral kinetics in HCV genotype 1 patients treated with peginterferon/ribavirin-based therapy. Our findings support the hypothesis that vitamin D influences viral response to peginterferon/ribavirin-based therapy.

Keywords

• ANTIVIRAL THERAPY; CHRONIC HEPATITIS; HEPATITIS C; VITAMIN D RECEPTOR GENE