Hypothetically, vitamin D levels might be assessed before starting antiviral therapy, which should be initiated only in the presence

of normal serum vitamin D values; in the presence of vitamin D deficiency, it might be preferable to correct the deficiency before starting antiviral therapy. The supposed relationship between the rapid slope of the HCV RNA level after therapy initiation and vitamin D suggests that the latter could Target Selective Inhibitor Library cell line amplify the immunological effect of IFN. In fact, beyond the classical actions related to calcium homeostasis and bone metabolism, vitamin D has emerged as a key regulator of the innate immunity response in humans.23, 29, 30 Can pretreatment serum vitamin D determination be a useful adjunct to IL-28B rs12979860 C/T polymorphism

evaluation in managing the treatment options for patients with chronic hepatitis C? This study demonstrated that the vitamin D level and the IL-28B rs12979860 C/T polymorphism are two independent predictors of SVR achievement in difficult-to-treat HCV genotypes. Moreover, our results clearly illustrate that these two predictors, being completely independent of each other, may be usefully Selleck Tanespimycin combined to enhance the ability to identify patients who will respond to treatment. Compared with patients carrying the IL-28B rs12979860 C/C genotype and who have a normal vitamin D level, vitamin D deficiency identifies patients with a lower probability of SVR attainment. Furthermore, carrying at least one T allele along with vitamin D deficiency was associated with the lowest probability of attaining the same viral endpoint. Although promising, this study has some limitations. First, it is retrospective. Second, Vildagliptin only a baseline vitamin D determination was available, and no further vitamin D levels could be included in the analysis. Therefore, we cannot

exclude that during antiviral treatment, vitamin D levels vary in relationship with a number of factors capable of influencing its level. However, in accordance with the data presented, vitamin D plays its major role during the initial phases of viral decline soon after initiating treatment, and although dependent on several environmental factors, vitamin D levels are probably at least in part genetically predetermined.31 In conclusion, the present study confirms a possible role for the serum vitamin D level in predicting the outcome of antiviral therapy in HCV chronic infection. Vitamin D deficiency is associated with a reduced probability of RVR attainment. The determination of this vitamin may be complementary to that of the IL-28B rs12979860 C/T polymorphism in enhancing the correct prediction of SVR achievement in treatment-naïve patients with chronic hepatitis C.