Positive correlation of 25'hydroxyvitamin D p lasma level and T helper activity in chronic hepatitis C patients

Abstract — The immune modulating role of vitamin D has been extensively studied but less documented in chronic infection with hepatitis C virus (HCV). The aim of our study was to assess the vitamin D status and adaptative immunity in HCV chronic infected patients. 46 patients were selected, 25 diagnosed with chronic hepatitis C infection and 21 healthy controls. HCV patients were classified according to the degree of hepatic necroinflammatory activity recorded using Actitest. A2-A3 scores were considered relevant for active HCV hepatitis, while A0-A1 indicated inactive HCV hepatitis. We measured: a) vitamin D status using 25-hydroxyvitam D plasma level (Elisa method) and the calcium-phosphorus equilibrium, b) the immune status according to the CD4+ T helper cells and CD8+ T helper cells detected by flow cytometry, and c) the extent of liver cytolysis disclosed by alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. All HCV patients, as well as healthy controls displayed a vitamin D deficiency (25-hydroxyvitamin D plasma level 29.571 nmol/l, and 29.271 nmol/l , respectively ). A strong positive correlation between 25-hydroxyvitamin D and CD4+ T helper cells (R= 0.703 Pearson correlation) was found in active HCV patients. Correlations between 25-hydroxyvitamin D and the ALT and AST levels were weak and divergent: positive in patients with active HCV hepatitis and negative in patients with inactive HCV hepatitis. Serum CD4+ T helper count in active HCV patients correlated positively with serum total calcium (R=0.841 Pearson correlation) and ionized calcium (R=0.652). In conclusion, positive correlations were recorded in active HCV hepatitis between the immune response (CD4+ T helper cells count), the plasma 25-hydroxyvitamin D, total serum calcium, and ionized calcium.