title: Vitamin D and the racial difference in the genotype 1 chronic hepatitis C treatment response.
abstract: BACKGROUND
  African Americans with genotype 1 chronic hepatitis C attain a sustained virologic response (SVR) at only approximately one-half the rate of whites after peginterferon and ribavirin treatment. The serum concentration of 25-hydroxyvitamin D [25(OH)D] has recently been established as a predictor of treatment response. Therefore, the low serum concentrations of 25(OH)D found among African Americans may contribute to the low response rate; however, to our knowledge, none of the studies of vitamin D in chronic hepatitis C treatment have included a significant number of black patients.
  
  
  OBJECTIVE
  The objective was to compare the relation between the 25(OH)D concentration and genotype 1 chronic hepatitis C treatment response in African Americans with that in whites.
  
  
  METHODS
  This cross-sectional analysis included 106 African American and 65 white patients with genotype 1 chronic hepatitis C.
  
  
  RESULTS
  Consistent with previous studies, we found that the SVR rate in the white patients increased significantly with an increasing serum concentration of 25(OH)D [SVR rates were 20%, 46%, and 70% for 25(OH)D serum concentrations <20, 20-35, and >35 ng/mL, respectively; P-trend = 0.008]; however, there was no relation between the SVR rate and 25(OH)D serum concentration in the African American patients [SVR rates were 32%, 28%, and 33% for 25(OH)D serum concentrations <20, 20-35, and >35 ng/mL, respectively; P-trend = 0.832]. We also found an analogous racial difference in the relation between the extent of liver fibrosis and the 25(OH)D concentration.
  
  
  CONCLUSIONS
  Racial differences in vitamin D physiology or race-specific factors that modify the effects of vitamin D may affect the immune response to genotype 1 hepatitis C virus.
authors.affiliation: Department of Medicine, St Louis Veterans Affairs Medical Center-John Cochran Division, St Louis, MO 63106, USA. sjweintraub@gmail.com
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Weintraub
authors.forename: Jacquelyn F
authors.initials: JF
authors.lastname: Fleckenstein
authors.forename: Tony N
authors.initials: TN
authors.lastname: Marion
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Madey
authors.forename: Tahar M
authors.initials: TM
authors.lastname: Mahmoudi
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Schechtman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000235:genetics*; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D016174:Hepacivirus / Q000378:metabolism*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000208:ethnology* / Q000235:genetics / Q000378:metabolism; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D014807:Vitamin D; D011092:Polyethylene Glycols; D012254:Ribavirin; C104450:25-hydroxyvitamin D; C100416:peginterferon alfa-2a