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Meta-Analysis
. 2019 Jun 11;19(1):84.
doi: 10.1186/s12876-019-1004-2.

Low vitamin D levels are associated with high viral loads in patients with chronic hepatitis B: a systematic review and meta-analysis

Ye-Chao Hu  1   2 , Wei-Wei Wang  1 , Wei-Yun Jiang  1 , Chun-Qing Li  1 , Jian-Chun Guo  1 , Yun-Hao Xun  3
Affiliations
Meta-Analysis

Low vitamin D levels are associated with high viral loads in patients with chronic hepatitis B: a systematic review and meta-analysis

Ye-Chao Hu et al. BMC Gastroenterol. .

Abstract

Background: Previous studies have investigated the vitamin D status in patients with chronic hepatitis B virus (HBV) infection and its relationship with HBV replication, the results however were inconsistent. The present meta-analysis was carried out to compare the vitamin D levels between patients with chronic hepatitis B (CHB) and healthy controls, and to determine whether vitamin D levels were correlated with HBV viral loads significantly.

Methods: A systematic search was conducted via PubMed, Web of Science, EMBASE and the Cochrane Library to identify eligible studies until September 28, 2017. We calculated pooled mean difference (MD) and 95% confidence intervals (CI) to quantitatively estimate the difference of vitamin D levels between CHB patients and controls. In addition, correlation between serum vitamin D levels and HBV viral loads was defined by summary correlation coefficient (r value) and the corresponding 95% CI.

Results: A total of 7 studies involving 814 CHB patients and 696 healthy controls were included. A significantly decreased vitamin D levels was found in CHB patients compared with healthy controls: pooled MD (95% CI) was - 2.03 ng/mL (- 2.60, - 1.46). Latitude-stratified subgroup analysis indicated this difference was more obvious in low latitude areas, with a bigger pooled MD (95% CI) of - 2.72 ng/mL (- 4.57, - 0.87). In addition, we observed an inverse correlation between serum vitamin D levels and HBV viral loads: pooled r (95% CI) was - 0.41(- 0.54, - 0.27).

Conclusions: Our results showed that vitamin D levels were lower in CHB patients than that of healthy controls and inversely correlated with HBV viral loads, although future comprehensive studies are needed to clarify the underlying mechanisms.

Keywords: 25-hydroxyvitamin D; Hepatitis B virus; Hepatitis B, chronic; Meta-analysis; Vitamin D deficiency.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study selection process
Fig. 2
Fig. 2
Forest plot of overall prevalence of vitamin D deficiency in patients with chronic hepatitis B
Fig. 3
Fig. 3
Forest plot of comparisons of vitamin D levels in CHB patients versus healthy controls
Fig. 4
Fig. 4
Sensitivity analysis for comparisons of vitamin D levels in CHB patients versus healthy controls
Fig. 5
Fig. 5
Funnel plot for publication bias analysis for vitamin D levels in CHB patients versus healthy controls
Fig. 6
Fig. 6
Subgroup analysis for comparisons of vitamin D levels in CHB patients versus healthy controls. Subtotals of low latitude and high latitude, and overall population
Fig. 7
Fig. 7
Forest plot of the association between vitamin D and HBV viral loads
Fig. 8
Fig. 8
Sensitivity analysis for the association between vitamin D and HBV viral loads
Fig. 9
Fig. 9
Funnel plot for publication bias analysis for the association between vitamin D and HBV viral loads
See this image and copyright information in PMC

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