Serum B12 levels predict response to treatment with interferon and ribavirin in patients with chronic HCV infection

Journal of Viral Hepatitis

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Serum B12 levels predict response to treatment with interferon and ribavirin in patients with chronic HCV infection

P. Rosenberg, K. Hagen
Journal of Viral Hepatitis: Volume 18,Issue 2, pages 129-134 February 2011

Summary

Background and Aim

Vitamin B12 is stored in hepatocytes and inhibits hepatitis C virus (HCV) RNA translation.
The implication of B12 in the setting of antiviral treatment is unknown.This study aims to retrospectively evaluate the discriminative efficacy of pretreatment B12 serum levels (s-B12) on end-of-treatment response (ETR) in patients with chronic HCV.

Patients and Methods

Ninety-nine treatment naive HCV patients, treated with interferon and ribavirin were studied.
Serum B12 (s-B12) was analysed in samples collected before treatment start.
Pretreatment s-B12 levels were correlated to ETR using univariate analysis.
S-B12 and clinical data were evaluated in a multivariate logistic regression model.

Results

  • Mean pretreatment s-B12 was 331pm in ETR and 260 pm in nonresponders (NR) (P< =0.012).
  • In patients with s-B12 levels less than 360 pm, 23 (31.5%) were NR and 50 (68.5%) had ETR.
  • In patients with s-B12 more than 360 pm, one (3.8%) was NR and 25 (96.2%) had ETR (P =?0.0034).

The results of the multivariate analysis were as follows:

  • Pretreatment s-B12 > 360 vs < 360 pm: OR 28.6 CI 2.31-354, P = 0.008.
  • Fibrosis stage 3-4 vs 0-2: OR 0.29 CI 0.074-1.12, P = 0.068.
  • Genotype 2/3 vs 1/4/5: OR 15.5 CI 2.87-83.9, P = 0.0012.
  • Dose reduction vs no dose reduction: OR 0.21, CI 0.048-0.91 P = 0.034.
  • Standard interferon vs pegylated-interferon: OR 0.079, CI 0.0091-0.68 P = 0.019.
  • Age and gender were not correlated to ETR.
  • S-B12 > 360 pm is independently correlated to ETR in HCV patients treated with interferon and ribavirin.

This suggests that B12 is involved in suppression of viral replication during anti-HCV treatment.


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