Assessment of bone metabolism and mineral density in chronic viral hepatitis

The aim of the study was to assess bone metabolism and impact of disease on bone mineral density in patients with non-cirrhotic chronic hepatitis B or C. 105 patients with chronic hepatitis B or C receiving antiviral agents and 60 healthy controls were included. Subgroups (n=15) were defined on the basis of age (males) or menopausal status (females). Bone mineral density; serum parathyroid hormone (PTH), calcium (Ca), phosphorus (P), total alkaline phosphatase, and 25-hydroxy vitamin D levels; 24-hour urinary levels of Ca and P; and urinary telopeptide (NTX) were measured. Statistical comparisons were made between patient groups and the matched controls. Compared to controls, the average serum levels of PTH were lower and 24-hour urinary mean Ca levels and T scores were higher in chronic hepatitis B patients between 20 and 40 years of age. Men with chronic hepatitis B and aged 40 - 65 years had lower mean serum P concentrations. Postmenopausal women with chronic hepatitis B had significantly higher NTX levels. Men with chronic hepatitis C had significantly elevated levels of 24-hour mean urinary P levels. The serum 25 OH vitamin D levels were significantly higher in premenopausal women with chronic hepatitis C. Postmenopausal women with chronic hepatitis C had significantly lower serum P concentrations. Other parameters and T scores did not differ significantly between patient groups and matched controls. Our results suggest that chronic hepatitis B and C infections do not pose a risk for osteoporosis and low bone mineral density.