Factors Attenuating Zinc Deficiency Improvement in Direct-Acting Antiviral Agent-Treated Chronic Hepatitis C Virus Infection

Ko, Yi-Ling; Morihara, Daisuke; Shibata, Kumiko; Yamauchi, Ryo; Fukuda, Hiromi; Kunimoto, Hideo; Takata, Kazuhide; Tanaka, Takashi; Inomata, Shinjiro; Yokoyama, Keiji; Takeyama, Yoshifumi; Shakado, Satoshi; Sakisaka, Shotaro

doi:10.3390/nu10111620

Cited by 15 publications

(14 citation statements)

References 27 publications

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“…Zinc has been shown to exhibit antiviral properties by inhibition of RNA synthesis, viral replication, DNA polymerase, reverse transcriptase, and viral proteases (Read et al, 2019;Ko et al, 2018;Xue et al, 2014). However, the literature is unclear regarding SARS-CoV-2 and zinc.…”

Section: Discussionmentioning

confidence: 99%

COVID-19: Poor outcomes in patients with zinc deficiency

Jothimani

Kailasam

Danielraj

et al. 2020

International Journal of Infectious Diseases

245

228

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Background: Zinc is a trace element with potent immunoregulatory and antiviral properties, and is utilized in the treatment of coronavirus disease 2019 (COVID-19). However, we do not know the clinical significance of serum Zinc levels in COVID-19 patients. The aim of this study was to determine the clinical significance of serum zinc in COVID-19 patients and to establish a correlation with disease severity. Methods: This was a prospective study of fasting zinc levels in COVID-19 patients at the time of hospitalization. An initial comparative analysis was conducted between COVID-19 patients and healthy controls. COVID-19 patients with zinc deficiency were compared to those with normal zinc levels. Results: COVID-19 patients (n = 47) showed significantly lower zinc levels when compared to healthy controls (n = 45): median 74.5 (interquartile range 53.4-94.6) mg/dl vs 105.8 (interquartile range 95.65-120.90) mg/dl (p < 0.001). Amongst the COVID-19 patients, 27 (57.4%) were found to be zinc deficient. These patients were found to have higher rates of complications (p = 0.009), acute respiratory distress syndrome (18.5% vs 0%, p = 0.06), corticosteroid therapy (p = 0.02), prolonged hospital stay (p = 0.05), and increased mortality (18.5% vs 0%, p = 0.06). The odds ratio (OR) of developing complications was 5.54 for zinc deficient COVID-19 patients. Conclusions: The study data clearly show that a significant number of COVID-19 patients were zinc deficient. These zinc deficient patients developed more complications, and the deficiency was associated with a prolonged hospital stay and increased mortality.

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Section: Discussionmentioning

confidence: 99%

COVID-19: Poor outcomes in patients with zinc deficiency

Jothimani

Kailasam

Danielraj

et al. 2020

International Journal of Infectious Diseases

245

228

View full text Add to dashboard Cite

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“…(23) In two recent studies, serum zinc levels were also found to change in HCV patients before and after DAA treatment. (24,25) However, the mechanism underlying these effects has not yet been clarified. It is known that the production of albumin is inhibited by acute phase cytokines, such as interleukin 6 and tumor necrosis factor a.…”

Section: Discussionmentioning

confidence: 99%

Predictors of hepatocellular carcinoma after hepatitis C virus eradication following direct-acting antiviral treatment: relationship with serum zinc

Ozeki

Nakajima

Suii

et al. 2020

J. Clin. Biochem. Nutr.

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The recently approved direct acting antivirals (DAA) agents are effective in terms of sustained virologic response (SVR) rates and are well tolerated in most hepatitis C virus (HCV) patients. This study aimed to analyze the association between serum zinc levels in patients who developed hepatocellular carcinoma (HCC) following HCV eradication after DAA treatment. The retrospective study included 769 HCV infected patients who achieved SVR after DAA treatment. We calculated the annual incidence rate of HCC and identified risk factors associated with HCC development. We also assessed serum zinc and clinical factors at both baseline and end of treatment (EOT). During follow up (median duration 35 months), HCC occurred in 18/769 (2.3%) patients. From the multivariate analysis, serum zinc <60 μg/dl [hazard ratio (HR) 5.936] and AFP ≥6.0 ng/dl (HR 5.862) at baseline, baseline zinc <60 μg/dl (HR 6.283), EOT serum zinc <63 μg/dl (HR 6.011), baseline AFP ≥6.0 ng/dl (HR 8.163), and EOT M2BPGi ≥2.5 (HR 12.194) at baseline and EOT were independently associated with increased HCC risk. In patients who achieved HCV eradication following DAA treatment, serum zinc levels before and at EOT could be a risk factor for developing HCC.

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“…Hepatitis C virus (HCV) infection induces steatosis and multiple metabolic alterations, including hyperuricemia, hypozincemia, reversible hypocholesterolemia, and insulin resistance …”

Section: Introductionmentioning

confidence: 99%

IL28B gene polymorphism is correlated with changes in low‐density lipoprotein cholesterol levels after clearance of hepatitis C virus using direct‐acting antiviral treatment

Morihara

Shibata

et al. 2019

J of Gastro and Hepatol

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Background: Direct-acting antivirals (DAAs) rapidly clear hepatitis C virus (HCV), but the lipid dynamics after DAA treatment remain unknown. Low-density lipoprotein (LDL) cholesterolemia is the predicting factor for the onset and death of atherosclerotic cardiovascular diseases. Thus, in this study, we examined the frequency and risk of hyper-LDL cholesterolemia in HCV patients who achieved sustained virologic response (SVR) with DAA treatment. Methods: A total of 121 patients with HCV genotype 1b, who achieved SVR with DAA treatment, were examined for serum levels of total cholesterol, LDL-cholesterol (LDL-C), high-density lipoprotein, and triglycerides from the start of treatment until 2 years after SVR (SVR-2y). ΔLDL-C was defined as the change in LDL-C levels from treatment initiation to SVR-2y. Hyper-LDL cholesterolemia was defined as ≥ 140 mg/dL LDL-C at SVR-2y. Stepwise multiple regression analysis was performed to determine whether ΔLDL-C and hyper-LDL cholesterolemia are associated with other factors, including viral kinetics. Results: A total of 63, 3, and 55 patients were administered daclatasvir + asunaprevir, ombitasvir + paritaprevir + ritonavir, and ledipasvir + sofosbuvir, respectively. ΔLDL-C in patients with the IL28B (rs8099917) TG/GG genotype was significantly higher than in those with IL28B TT (27.3 ± 27.0 and 9.6 ± 27.3 mg/dL; P < 0.001). In addition, IL28B TG/GG was an independent risk factor for hyper-LDL cholesterolemia (odds ratio: 8.47; P < 0.001). Conclusions: An IL28B polymorphism is associated with ΔLDL-C and hyper-LDL cholesterolemia after achieving SVR. Thus, lipid markers should be carefully monitored in patients who achieve SVR with DAA.

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Factors Attenuating Zinc Deficiency Improvement in Direct-Acting Antiviral Agent-Treated Chronic Hepatitis C Virus Infection

Cited by 15 publications

References 27 publications

COVID-19: Poor outcomes in patients with zinc deficiency

COVID-19: Poor outcomes in patients with zinc deficiency

Predictors of hepatocellular carcinoma after hepatitis C virus eradication following direct-acting antiviral treatment: relationship with serum zinc

IL28B gene polymorphism is correlated with changes in low‐density lipoprotein cholesterol levels after clearance of hepatitis C virus using direct‐acting antiviral treatment

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