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3 {!$.c (!2 5/0)!<. 3 I {$.c (2 33/3) (!2 58/3)!<. 35 II {!$.c (!2 1/7)!<. 1 Ia..$ IIIb {$.c (2 1/7) <. 1 III {$.c!!) $! *!7 D " ]B "K. /A o:4 $ 29/60 ± 13/61 26/23 ± 18/53 ]B! 8! $ 2 Q+!).(P = 0/260)!@. *@ *7 " (2 5/0) <. 3 K o6. * H *7 D " *!7!!.$ D "! "!( ]B! $ *7 *!7 "!/s.!@. *!@ D " $ 3 ) (!2 60/0)!<. 36 ) *7 (2 71/7) <. 43 $ 8! $ Fisher's exact &$! H 5!6 /!) D "! $!!)!/A o:!4 *!7 D "! $.3.(2 -O) (P = 0/033)! D "! ]B " " * H. %d &$! H 5!6!!) $!O 0/09 &#!! V1!% K% D "! ]B "/s.(p = 0/330) $. /A Pearson / *7 P' 27/3 ± 15/6 29/5 ± 19/3 24/9 ± 10/7!!!!!!@ &$!!! H 5!!!6 $!!!!!!G!!! 97$.!!!. 34/5 ± 20/0 /! *!7!%d! D "! ]B! One-way ANOVA.(P = 0/430) $. U<! &!. &! D "! ]B "K. "/s!/a U< $ 31/00 ± 24/20 27/46 ± 14/90 D "! ]B "/s.@. *@ E/O " "! "! ]B!! &!@. 0! {!$.c!%d! 29/05 ± 22/20!!!! IIIa III II Ia I!!{!!$.c &$! H 5!6 $ 24/00 25/10 ± 17/60 28/00 19/80 ± 4/30 #!. 0! {$.c D " ]B " One-way ANOVA.(P = 0/920) ). $O /A H r "!( ]B! (Deficient <!G!! 97$.!. 10) D " 3!! ]B!! (Insufficient!!G!!!! 97$.!! )!! ]B!! (Sufficient!!G!!!! 97$.!! ).) 37 q. (Toxicity > G 97$..!R!?!! *!//!AO &A " ) *7!.$ C.$<; F$. : 100)...) _?. /) 1B $ *7 E/O " xig? $ 5# C : B4 VP Q $; *7 & ".)... f$+@ %/O 0.!) &%? $ 5# y$n4 Q $; " q. C! D "! U!p y$n4 &$ *<!!!)!. H8!O!A AGB *. q. (version 23, SPSS Inc., Chicago, IL) 23?!%. SPSS #39. 2!&$! H one-way ANOVA χ t Q!!!I!!!#W $!!! Spearman Pearson! H!&$! H K!!!%.37 C!3 60 ($! *!7) C : 60 AGB "!AGB $! (!) *!7)!1#? $ *// on!!!) $! *7 " "K../37 C "! /A o:4 $ - 34/93 ± 7/94 36/63 ± 8/17 (! /& ) %/O %..(P = *@ *7 "!/A o:!4 $ 50/10 ) *7 55/5 $ *7 8!! $ 1 -!!O.(P = 0/170)!!@. *!!@ *!!7 "!!. * H *7 37$ p $! &! 0! {!$.c! Q+)!<. 20 *! H!!!.!%d!.! *! H!AGB.1 P 0/170 34/93 ± 7/94 36/63 ± 8/17 "+,+ " 0/ (31/7) 17 (28/3) 30 0 % / 23 (38/3) 26 (43/3) (26/7) 12 (20/0) (3/3) 5 (8/3) % +5 $ 50 0/ (83/3) 55 (91/7) % (16/7) 5 (8/3) 0 51

4 {!$.c " #. Spearman K% &$ H 9W. #$'($ ٨ ٠ 0/08 &#!! 0$!+A K% D " ]B 0.(P = 0/530) $!.!/A! H!q.!!) $!O {$.c 37$ p %d D " ]B 3 -O. * H 0 D & % 1/7IIIb: IIIb: ١ /٧ III: ٨ /٣ I: ٣٣ /٣ # D 3 4"5 %75 %25., / ).2 # III58/3% Ia: 5/0% Ia: /٠ # # D 3 4"5 +).2 ()! P = 0/033 0 (0/0) 36 (60/0) 24 (40/0) 60 (100) ()! 3 (5/0) 43 (71/7) 14 (23/3) 60 (100) D (Deficient) 9:/ (Insufficient) &/ (Sufficient) &/ ;8 II: II: 1/7% ١ /٧!" # $#%& # ' ()* +),#.1 &!@.!AGB!* %WG &$7 &$ H 9W. D " ]B {$.c E/O " p }./). C { : /A 789 & # # D 3 4"5 +).3 $ # $ # % "# $ # $ # % "# 6 (31/6) 13 (68/4) 4 (23/5) 11 (64/7) 2 (11/8) < 30 7 $%< 10 (43/5) 13 (56/5) 7 (26/9) 19 (73/1) (43/8) 9 (56/3) 7 (26/9) 19 (83/3) 1 (8/3) (50/0) 1 (50/0) 2 (40/0) 3 (60/0) 50 0/860 0/370 P = 21 (42/0) 29 (58/0) 13 (23/6) 39 (70/9) 3 (5/5) % (30/0) 7 (70/0) 1 (20/0) 4 (80/0) 0 0/730 0/990 P = 5 (25/0) 14 (70/0) 1 (5/0) I >+?9@ 3 (100) Ia 1 (100) II 9 (25/7) 24 (68/6) 2 (5/7) III 1 (100) Ib 0/980 P = 52

5 ! AGB.(14) $) #. D " "( (!4!AGB 3 *@ AGB 8) AGB 11 F$W! HCV! 1575 "!!@./!) "!( UAGB " *) D "! ]B! (2 71) < (8).$ / *I & C & D ". R1. &+ Fisher &! <. 58 F$W &H.. C $ " #.! *!7 3!n U$!2 HCV I {$.c!d ! "! +!<GH B2 Pegylated &!3/ &! "! + <GH B2 Pegylated &3/ #. D3 " $!6 D " *// *< *7.. C D3 " *!@ (27 13) ) *7 %. J SVR PO$ QC D "! Q!+ // P/@( AGB " &7/%$..7 "G$!%.!! 1 $!P 5!6 l( "+ HCV! 468.(11) R#3 Q+!@ &GH K.)b7 AGB!{!$.c : & D " "( k$b &@. &!11I "!.!%.! I {!$.c!! III II $! ( V!%3$!( :!%-α1!!/3 "!/s PO$ QC &# D " k$b CYP27B $!P!O$ D " Q+.(4) Z K K.)b7 AGB SVR C! $!;.$( & Y & l( G/K -$+G$ D " q. "/s.(4) ) #! & -A3 &H $O ) c3 d!ga3 ]B!!! *!) * &@. Chojkier. 9 J c3 AGB.(13)!/!!(!p D "! ]B! Up c3!%. " # C :!"!( D "! ]B! & &+ Bauman!/A AGB $!6!!;!3! :! &!!%!! "!).(14).$ $4 t/!% D " 3. ]B " # $!'!@ _!' : & ) $n! :! &!!! *!) +!)H &$/ /% D "!+G! _!' +G /. V@.(./% "( D " ]B : `A #. " # C! *!/#3 $6 D " ]B < U O$ 9! 25-OH Vit D!7*!.! *!) 4/!) &$/; "+ &H /#KO &' *~ 8 $O 8) O D " $!% " " $ r.7 _$%I $@.$<; Q2< &$? q. U!AGB!4 *~!. 37 C $ "! &! l( C : ) * &@. *!) w#7. ) Z D " ]B #.! $!@!K o!6! U!<!? U!AGB!AGB! 60 "! t! *!@. 9W. $ " 3 UAGB. 9W. D " ]B "A o Yd &!@.!Yd!AGB * H. D "! 3! ]B!!2 23/3 P/ C :! " : $2 t.$ &! D "! $! F$!).$ D " 3 ]B 5!6 $ </ HCV 3 J /A $6 &! l( &#.$ HCV D " $ C $).) J! k$b!.* &@. UAGB 4 r " l!( Q1!% *!// $!7R!( >4) 9 D " & A (SVR Sustained viral response) (! :!!3 D "! Q+ on Y!H!!! J! SVR (CHC) Chronic hepatitis C D "! "!( k$b!!!! &!@. G *.(4 11) Pegylated interferon!!!y & l( K.$K'! b!7 (RVB Ribavirin) " (PEG-IFN)!.! R#3 ( l( 2 D " Q+! D "! $!!!. &@. &+ Lange PEG-IFN! *!) &! ) -d " &!!P/ "!( SVR &#!.!) $!O III II {!$.c! (< 24 $ F$) Yd AGB /'.(4) U RBV 1 {$.c & F$!) ). /A U<? {$.c D "!2 100 II {!$.c!2 80/2 I {$.c &H.$ 2 75 III {$.c $J!!!!!!!! $/ y$!!!!!!!!4 D "!!!!!!!! 0!!Y! U$!2!! (Immunomodulatory)! l!( (13)!/! Q!; In vitro Z) HCV " #! C!! :! &! &!3/ 0!! & ]B! CHC! :! &.@? $P (CHC) 53

6 ! 2$ "Y ".7 & )P V% Q!C C : & $) UAGB 9W.!C! $! D "! ]B q. & F) &!.H D "! Q!+ #$W O.O U C.7.$) 9W. $%( )*!.!C &$!4! V.4 3d.&( Q2d Yd G1 *+!@.!@~(!.A *!)!!!!d! $!n &P<2 +)#( 9$; *K@. +)#(.7 O &@ (CLD! Chronic liver disease) " # : CLD! :! & D " $ ' t$) 37q. "!!) $!!&H 3/1 QC!d (2 92) " U!AGB!K!!3!AGB "!!.!!O$! F$!)! " ) AGB " &$ 7W.!/A $!6! C! : & D " $ "! "! $! J! F$) ) *7 3 J R!!.$!!&H +; 9. *:;! *:!;!)!) PO$ QC C & < J! nc /# QI W/ & /3 &.J$6 References 1. Beltran M, Navas MC, de la Hoz F, Mercedes MM, Jaramillo S, Estrada C, et al. Hepatitis C virus seroprevalence in multi-transfused patients in Colombia. J Clin Virol 2005; 34(Suppl 2): S33-S Zahedi MJ, Zand V, Tavakoli M, Hajarizadeh B, Alavian SM. The prevalence of hepatitis B and C among thalassemia major patients in Kerman, Iran, and the role of transfusion in infection acquisition. Govaresh 2003; 8(44): [In Persian]. 3. Hosseinnezhad A, Javadi E, Maghbooli Z, Madani FS, Ardeshir Larijani MB. Normal range of vitamin D: relationship between serum PTH and bone mineral density. Payesh Health Monit 2004; 3(1): [In Persian]. 4. Lange CM, Bojunga J, Ramos-Lopez E, von Wagner M, Hassler A, Vermehren J, et al. Vitamin D deficiency and a CYP27B promoter polymorphism are associated with chronic hepatitis C and poor response to interferon-alfa based therapy. J Hepatol 2011; 54(5): White JH. Vitamin D signaling, infectious diseases, and regulation of innate immunity. Infect Immun 2008; 76(9): Arteh J, Narra S, Nair S. Prevalence of vitamin D deficiency in chronic liver disease. Dig Dis Sci 2010; 55(9): Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004; 79(3): Lim LY, Chalasani N. Vitamin D deficiency in patients with chronic liver disease and cirrhosis. Curr Gastroenterol Rep 2012; 14(1): Bouillon R, Auwerx J, Dekeyser L, Fevery J, Lissens W, de Moor P. Serum vitamin D metabolites and their binding protein in patients with liver cirrhosis. J Clin Endocrinol Metab 1984; 59(1): Petta S, Camma C, Scazzone C, Tripodo C, di Marco V, Bono A, et al. Low vitamin D serum level is related to severe fibrosis and low responsiveness to interferon-based therapy in genotype 1 chronic hepatitis C. Hepatology 2010; 51(4): Fisher AA, Davis MW. Calcium-PTH-vitamin D axis in older patients with hip fracture. Osteoporos Int 2007; 18(5): Fisher L, Fisher A. Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clin Gastroenterol Hepatol 2007; 5(4): Chojkier M. Effects of vitamin D on inflammation in liver disease [Online]. [cited 2012 Dec]; Available from: URL: Bauman WA, Zhong YG, Schwartz E. Vitamin D deficiency in veterans with chronic spinal cord injury. Metabolism 1995; 44(12):

7 Journal of Isfahan Medical School Received: Vol. 34, No. 370, 2 nd Week, April 2016 Accepted: Serum Levels of 25-Hydroxy Vitamin D in Patients with Hepatitis C Compared with Control Group Abstract Behrouz Ataei 1, Zahra Akhavan-Ghorbani 2, Farzin Khorvash 1, Amirmohammad Ataei 2 Background: Some studies suggest that besides the known effects of vitamin D on calcium hemostasis and bone safety, it might also play a non-classic role in our body such as in chronic hepatic disorders. So, considering the high prevalence of vitamin D deficiency and hepatitis C virus (HCV) in our society, the aim of this study was to evaluate serum levels of vitamin D in HCV patients compared to a control group. Methods: In this case-control study, 60 HCV patients and 60 healthy pupils were selected and serum level of vitamin D was measured and compared between the two groups. Findings: The mean serum level of Vitamin D in the case and control group was ± and 29.6 ± 13.61, respectively and no statistical difference was reported between the two groups (P = 0.260). Vitamin D insufficiency was found in 3 patients (5.0%) in the case group and none of the control group. Vitamin D deficiency was found in 43(71.7%) of the case group but only 6 (10.0%) of the control group and this difference between the two group was statistically significant (P = 0.033). Conclusion: According to the results of this study, vitamin D deficiency in HCV patients was higher than the normal population and high prevalence of vitamin D deficiency can affect other organs and decrease the quality of HCV treatment. Thus, measuring the serum levels of vitamin D in HCV patients and prescribing vitamin D supplements are recommended. Keywords: Hepatitis C, Vitamin D, Vitamin D deficiency Original Article Citation: Ataei B, Akhavan-Ghorbani Z, Khorvash F, Ataei A. Serum Levels of 25-Hydroxy Vitamin D in Patients with Hepatitis C Compared with Control Group. J Isfahan Med Sch 2016; 34(370): Associate Professor, Department of Infectious Diseases, School of Medicine AND Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2- Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Corresponding Author: Zahra Akhavan-Ghorbani, z_akhavan2008@yahoo.com 55