Vitamin D deficiency in chronic hepatitis B across the disease spectrum: association with viral activity rather than hepatocellular carcinoma

Chronic liver disease is often associated with vitamin D deficiency. However, the relationship between vitamin D deficiency and HBV disease severity, viral activity, and HCC remains unclear. We evaluated whether vitamin D deficiency is linked to the disease stage and HBV viral activity in chronic hepatitis B (CHB) and whether HCC is an independent predictor of vitamin D status. This study at Ibn Sina Diagnostic Center, Dhaka, included 510 participants: chronic hepatitis B (CHB, n = 210), liver cirrhosis (LC, n = 150), hepatocellular carcinoma (HCC, n = 100), and healthy controls (HC, n = 50). Serum 25-hydroxyvitamin D and HBV DNA were measured using standard assays and real-time PCR. Group comparisons, regression analyses, and exploratory in silico analyses (STRING PPI and docking with VDR and STAT1) were performed. According to the findings of multivariable analysis, the levels of HBV DNA were found to be independently related to baseline vitamin D status. In contrast to this, the levels of HCC were not found to be independently related after adjustment. Univariate analysis of vitamin D and HBV DNA showed a weak correlation, suggesting the necessity to model for confounders. Enrichment of host-guiding PPI illustrated interferon-associated immune pathways, whereas docking substantiated compatibility of a calcitriol molecule with VDR and STAT1, by context hypothesis generating usefulness. Chronic HBV infection suggests that vitamin D status relates more to viral activity in the host immune regulatory milieu than to HCC as an independent determinant. Making a statement about explanatory chronology is the first step.