Genetic variation in the vitamin D pathway CYP2R1 gene predicts sustained HBeAg seroconversion in chronic hepatitis B patients treated with pegylated interferon: A multicenter study

PLoS One. 2017 Mar 15;12(3):e0173263. doi: 10.1371/journal.pone.0173263. eCollection 2017.

Abstract

Evidence of a role of vitamin D in the immune system is increasing. Low serum vitamin D is associated with increased hepatitis B virus replication. Genome-wide association study (GWAS) data has revealed a number of the single nucleotide polymorphisms (SNPs) within the vitamin D synthetic pathway that affect vitamin D functions. We aimed to determine the association between SNPs in the vitamin D gene cascade and response to pegylated interferon (PegIFN) therapy in hepatitis B e-antigen (HBeAg)-positive patients. One hundred and eleven patients treated for 48 weeks with PegIFN-alfa 2a at 13 hospitals were retrospectively evaluated. Thirteen SNPs derived from vitamin D cascade-related genes, including DHCR7 (rs12785878), CYP27B1 (rs10877012), CYP2R1 (rs2060793, rs12794714), GC (rs4588, rs7041, rs222020, rs2282679), and VDR (FokI, BsmI, Tru9I, ApaI, TaqI), were genotyped. Thirty-one patients (27.9%) seroconverted to HBeAg after 24 weeks of treatment. Multivariate analysis found pretreatment qHBsAg <10,000 IU/mL (OR = 7.73, 95% CI: 2.36-25.31, P = 0.001), CYP2R1 rs12794714 TT genotype (OR = 4.16, 95% CI: 1.07-16.25, P = 0.04), and baseline ALT >2 times the upper limit of normal (OR = 3.83, 95% CI: 1.31-11.22, P = 0.014) predicted sustained HBeAg seroconversion after completion of PegIFN treatment. HBV DNA during study period tended to be lower with the rs12794714 CYP2R1 TT than the non-TT genotype. The rs12794714 CYP2R1 polymorphism may be a useful pretreatment factor predictive of sustained HBeAg seroconversion after PegIFN therapy. This study provides evidence that not only vitamin D level but also genetic variation of CYP2R1 in the vitamin D cascade influences host immune response in chronic HBV infection.

Publication types

  • Multicenter Study

MeSH terms

  • Cholestanetriol 26-Monooxygenase / genetics*
  • Cytochrome P450 Family 2 / genetics*
  • Hepatitis B Core Antigens / immunology*
  • Hepatitis B e Antigens / immunology*
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Interferon-alpha / therapeutic use*
  • Polyethylene Glycols / therapeutic use*
  • Recombinant Proteins / therapeutic use

Substances

  • Hepatitis B Core Antigens
  • Hepatitis B e Antigens
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Cytochrome P450 Family 2
  • CYP2R1 protein, human
  • Cholestanetriol 26-Monooxygenase
  • peginterferon alfa-2a

Grants and funding

The research funding was supported by Thai Association for the Study of the Liver (THASL), the Ratchadaphiseksomphot Endowment Fund Part of the “Grants for Junior or Terminated Executive staff” (CU’s SRP_05_55_30_01), the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University (RA55/24) and the Pericardia Program of The Royal College of Physicians of Thailand. Part or partial of the laboratory work was supported by The National Research Council of Thailand (NRCT), The Research Chair Grant from the National Science and Technology Development Agency, The Center of Excellence in Clinical Virology of Chulalongkorn University (GCE 58-014-30-004) and King Chulalongkorn Memorial Hospital.