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Changes in serum zinc levels in hepatitis C patients before and after treatment with direct‐acting antiviral agents
Author(s) -
Suda Toshikuni,
Okawa Osamu,
Shirahashi Ryosaku,
Tokutomi Naohiko,
Tamano Masaya
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13409
Subject(s) - medicine , zinc , gastroenterology , cirrhosis , serum albumin , albumin , hepatitis c virus , subclinical infection , hepatitis c , zinc deficiency (plant disorder) , immunology , virus , pathology , chemistry , organic chemistry , micronutrient
Aim Zinc supplementation therapy has been shown to improve the prognosis of patients with hepatitis C virus (HCV) infection. However, little is known about the changes in serum zinc levels with treatment using direct‐acting antiviral agents (DAAs). This prospective study investigated the changes in serum zinc levels before and after treatment with DAAs in hepatitis C patients. Methods Thirty‐one patients with chronic hepatitis C or HCV‐related compensated cirrhosis who were treated with DAAs (glecaprevir/pibrentasvir or elbasvir/grazoprevir) were included in the study. Serum zinc and serum albumin levels were measured before DAA treatment (Baseline), at the end of treatment (EOT), and at 12 weeks after EOT (Follow‐up 12). The changes over time in the serum zinc and serum albumin levels were investigated. Results The mean age of the patients was 68.5 ± 12.1 (range, 40–86) years, and 17 (55%) were women. Based on the Japanese Society of Clinical Nutrition diagnostic criteria, 6 patients had zinc deficiency (<60 μg/dL), and 21 patients had subclinical zinc deficiency (60–80 μg/dL). Significant differences in serum zinc levels were seen between Baseline and EOT ( P = 0.01) and between EOT and Follow‐up 12 ( P = 0.0003). There was no significant difference in serum albumin levels between Baseline and EOT ( P = 0.76), but a significant increase was seen between EOT and Follow‐up 12 ( P = 0.01). Conclusions Increases in serum zinc are directly related to DAA treatment and are not a result of increases in albumin. Inhibition of the non‐structural protein (NS)3 and NS5A by DAAs could be associated with the improvement of serum zinc levels in hepatitis C patients.