Vitamin B12 acts as a natural inhibitor of hepatitis C virus
replication. A recent experiment was
conducted to assess the effect of vitamin B12 on virological response in
patients with chronic HCV naïve to antiviral therapy.
In the experiment, Ninety-four patients with chronic HCV
hepatitis were randomly assigned to receive pegylated interferon α plus ribavirin
or SOC plus vitamin B12 (SOC+B12). Viral response was evaluated four weeks
after starting treatment (rapid viral response), 12 weeks after starting
treatment (complete early viral response) and 24 or 48 weeks after starting
treatment (end-of-treatment viral response) and 24 weeks after completing
treatment (sustained viral response (SVR)).
Overall, rapid viral
response did not differ between the two groups, whereas the rates of complete
early viral response, end-of-treatment viral response and SVR were
significantly higher in SOC+B12 patients than in SOC patients. In SOC+B12 patients,
the SVR rate was also significantly higher in carriers of a difficult-to-treat
genotype and in patients with a high baseline viral load. Distribution of
genotype IL-28B did not differ between the two groups.
At multivariate analysis, only easy-to-treat HCV genotypes
(OR=9.00; 95% CI 2.5 to 37.5; p=0.001) and vitamin B12 supplementation (OR=6.9;
95% CI 2.0 to 23.6; p=0.002) were independently associated with SVR. In conclusion, vitamin B12 supplementation
significantly improves SVR rates in HCV-infected patients naïve to antiviral
therapy.
