Antonio Riccardo Buonomo1, Emanuela Zappulo2, Riccardo Scotto2, Biagio Pinchera2, Giuseppe Perruolo3, Pietro Formisano3, Guglielmo Borgia2, Ivan Gentile2. 1. Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Italy. Electronic address: antonioriccardobuonomo@gmail.com. 2. Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Italy. 3. Department of Medical Translational Sciences, University of Naples "Federico II", Italy.
Abstract
OBJECTIVES: To evaluate the prevalence of vitamin D deficiency and its impact on infections in HCV-related liver cirrhosis. METHODS: We enrolled 291 patients affected by HCV-related liver cirrhosis. Serum vitamin D levels were dosed at enrolment. The presence of infection was assessed at baseline and during follow-up based on physical examination and laboratory analyses. RESULTS: Vitamin D deficiency (<20ng/mL) was diagnosed in 68.3% of patients, and a total of 102 infections were detected. Urinary tract infections were the most common infections diagnosed (41.2%). Vitamin D deficiency rates were higher in patients with decompensated cirrhosis (Child-Pugh B vs A p=0.008, and Child-Pugh C vs A p=0.024). Infection was significantly associated with vitamin D deficiency (p<0.001), MELD score >15 (p=0.003), Child-Pugh class B/C vs A (p<0.001), and active hepatocellular carcinoma (HCC) (p<0.001). At multivariate analysis, vitamin D deficiency (p<0.01), HCC (p<0.05), hospitalization (p<0.001) and exposure to immunosuppressant agents (p<0.05) were independent risk factors for infection at baseline. CONCLUSIONS: Vitamin D may play a role in the development of infections in patients affected by liver cirrhosis, and preventive strategies with vitamin D supplementation are to be evaluated in randomized controlled trials.
OBJECTIVES: To evaluate the prevalence of vitamin D deficiency and its impact on infections in HCV-related liver cirrhosis. METHODS: We enrolled 291 patients affected by HCV-related liver cirrhosis. Serum vitamin D levels were dosed at enrolment. The presence of infection was assessed at baseline and during follow-up based on physical examination and laboratory analyses. RESULTS:Vitamin D deficiency (<20ng/mL) was diagnosed in 68.3% of patients, and a total of 102 infections were detected. Urinary tract infections were the most common infections diagnosed (41.2%). Vitamin D deficiency rates were higher in patients with decompensated cirrhosis (Child-Pugh B vs A p=0.008, and Child-Pugh C vs A p=0.024). Infection was significantly associated with vitamin D deficiency (p<0.001), MELD score >15 (p=0.003), Child-Pugh class B/C vs A (p<0.001), and active hepatocellular carcinoma (HCC) (p<0.001). At multivariate analysis, vitamin D deficiency (p<0.01), HCC (p<0.05), hospitalization (p<0.001) and exposure to immunosuppressant agents (p<0.05) were independent risk factors for infection at baseline. CONCLUSIONS:Vitamin D may play a role in the development of infections in patients affected by liver cirrhosis, and preventive strategies with vitamin D supplementation are to be evaluated in randomized controlled trials.