Vitamin D deficiency and hepatitis viruses-associated liver diseases: A literature review

World J Gastroenterol. 2018 Jan 28;24(4):445-460. doi: 10.3748/wjg.v24.i4.445.


The secosteroid hormone vitamin D has, in addition to its effects in bone metabolism also functions in the modulation of immune responses against infectious agents and in inhibiting tumorigenesis. Thus, deficiency of vitamin D is associated with several malignancies, but also with a plethora of infectious diseases. Among other communicable diseases, vitamin D deficiency is involved in the pathogenesis of chronic liver diseases caused by hepatitis B and C viruses (HBV, HCV) and high prevalence of vitamin D deficiency with serum levels below 20 mg/mL in patients with HBV and HCV infection are found worldwide. Several studies have assessed the effects of vitamin D supplementation on the sustained virological response (SVR) to interferon (IFN) plus ribavirin (RBV) therapy in HBV and HCV infection. In these studies, inconsistent results were reported. This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBV- and HCV-related chronic liver diseases. Furthermore, current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.

Keywords: Chronic liver disease; Hepatitis B virus infection; Hepatitis C virus infection; Hepatocellular carcinoma; Liver cirrhosis; Sustained virological response; Vitamin D; Vitamin D deficiency; Vitamin D supplementation.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Disease Progression
  • Drug Therapy, Combination / methods
  • Hepacivirus / isolation & purification
  • Hepacivirus / physiology
  • Hepatitis B virus / isolation & purification
  • Hepatitis B virus / physiology
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / immunology*
  • Hepatitis B, Chronic / virology
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / immunology*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferons / therapeutic use
  • Ribavirin / therapeutic use
  • Sustained Virologic Response
  • Viral Load / drug effects
  • Vitamin D / blood
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / immunology*


  • Antiviral Agents
  • Vitamin D
  • Ribavirin
  • Interferons