Sitkar A. D.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Introduction. More than 71 million people, or about 1% of the world’s population, are infected with the hepatitis C virus. The main clinical form of this infection is chronic hepatitis C, which develops in an average of 70% of patients. Metabolic disorders caused by the chronic hepatitis C infection include changes in the metabolism of trace elements, in particular zinc (Zn), copper (Cu) and selenium (Se), since their basic metabolism takes place in the liver. Violation of the homeostasis of these trace elements can increase hepatitis C virus replication and liver fibrosis and reduce the effectiveness of antiviral therapy, which determines the relevance of researching the levels of these trace elements in such patients. The aim. Evaluate the content of trace elements Zn, Cu and Se in the blood serum of patients with chronic hepatitis C depending on sex, age and body mass index. Materials and methods. 62 patients with a verified diagnosis of chronic hepatitis C were under observation, in whom the level of Zn, Cu and Se in blood serum was determined. The control group consisted of 30 healthy people. Results. There was no statistically significant difference between the studied groups depending on age (p=0,16), sex (p=0,747) and body mass index (p=0,319), i.e. they were homogeneous. The proportion of patients with chronic hepatitis C in whom the serum Zn level was below normal was 19,4% (12/62). The level of Zn was statistically significantly lower in patients with chronic hepatitis C compared to healthy people (0,649 (0,569; 0,739) mg/l vs. 0,720 (0,645; 0,835) mg/l; p=0,022). The detected levels of Cu and Se in the examined persons did not exceed the normal limits, and no statistically significant difference was established between the groups regarding the level of Cu (р=0,069) and Se (р=0,149). In patients with chronic hepatitis C, the average levels of trace elements in both men and women were almost at the same level and did not differ statistically significantly (р>0,05). The levels of the studied trace elements did not depend on the body mass index and did not correlate with age in both groups (p>0,05). A weak degree of negative correlation (ρ=–0,271, p=0,033) was found between the levels of Zn and Cu in patients with chronic hepatitis C. The average value of the Cu/Zn ratio in the group of patients was statistically significantly higher compared to the healthy people (p=0,002). Conclusions. The obtained data indicate a probable effect of chronic hepatitis C infection on the level of Zn in blood serum, which creates prerequisites for further research.

chronic hepatitis C,trace elements,zinc.

1. Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, et al. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. The lancet Gastroenterology & hepatology. 2017 Mar 1;2(3):161-76. DOI: 10.1016/S2468- 1253(16)30181-9.
2. Sierhieieva TA. Hepatyt С v Ukraini: zakhvoriuvanist, poshyrenist, seroprevalentnist, seromonitorynh. Clinical immunology. Allergology. Infectology. 2020;5(126):5-16. Dostupno: https://kiai.com.ua/ua/archive/ 2020/5%28126%29/pages-5-16/gepatit-s-v-ukrayinizahvoryuvanist-poshirenist-seroprevalentnist-seromonitoring. [in Ukrainian].
3. Gottschall CB, Pereira TG, Rabito EI, Álvares-Da-Silva MR. Nutritional status and dietary intake in non-cirrhotic adult chronic hepatitis C patients. Arq Gastroenterol. 2015 Jul-Sep;52(3):204-9. DOI: 10.1590/S0004-28032 015000300010.
4. Gupta S, Read SA, Shackel NA, Hebbard L, George J, Ahlenstiel G. The role of micronutrients in the infection and subsequent response to hepatitis C virus. Cells. 2019 Jun 17;8(6):603. DOI: 10.3390/cells8060603.
5. Mohamed AA, Abbassi MM, Hamed WA, EzzEl-Arab MA, Aref AM. Can zinc levels predict response to pegylated-interferon and ribavirin therapy in hepatitis C genotype 4 infected Egyptian patients? Acta Gastroenterol Belg. 2014 Jun;77(2):217-23. Available from: https:// pubmed.ncbi.nlm.nih.gov/ 25090819/.
6. Pourhassan A, Fouladi DF, Samani SM, Morshedi Asl S. Serum Zinc and Haptoglobin in Noncirrhotic Azeri Patients with Chronic Active Hepatitis C: a Case–Control Study. Biological trace element research. 2015 Oct;167(2):187-93. DOI: 10.1007/s12011-015-0309-4.
7. Guo CH, Chen PC, Lin KP, Shih MY, Ko WS. Trace metal imbalance associated with oxidative stress and inflammatory status in anti-hepatitis C virus antibody positive subjects. Environmental toxicology and pharmacology. 2012 Mar 1;33(2):288-96. DOI: 10.1016/j. etap.2011.12.018.
8. Cesur S, Cebeci SA, Kavas GO, Yılmaz N, Buyukkagnici DI. Serum copper and zinc concentrations in patients with chronic hepatitis C. Journal of Infection. 2005 Jul 1;51(1):35-7. DOI: 10.1016/j.jinf.2004.08.003.
9. Ko YL, Morihara D, Shibata K, Yamauchi R, Fukuda H, Kunimoto H, et al. Factors attenuating zinc deficiency improvement in direct-acting antiviral agent-treated chronic hepatitis C virus infection. Nutrients. 2018 Nov 2;10(11):1620. DOI: 10.3390/nu10111620.
10. Gupta SHH, Read S, Wijaya R, George J, Ahlenstiel G. The effect of fibrosis and direct-acting antiviral therapy on serum zinc levels in chronic hepatitis C infection. J. Gastroenterol. Hepatol. 2018;33:34-81. DOI: 10.3390/cells8060603.
11. Mohommad M. Zhou Z, Cave M, Barve A, McClain CJ. Zinc and liver disease. Nutr Clin Pract. 2012;27(1):8-20. DOI: 10.1177/088453361143 3534.
12. Lin CC, Huang JF, Tsai LY, Huang YL. Selenium, iron, copper, and zinc levels and copper-to-zinc ratios in serum of patients at different stages of viral hepatic diseases. Biological trace element research. 2006 Jan;109(1):15-23. DOI: 10.1385/BTER:109:1:015.
13. Khan MS, Dilawar S, Ali I, Rauf N. The possible role of selenium concentration in hepatitis B and C patients. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association. 2012 Mar;18(2):106. DOI: 10.4103/1319-3767.93811.
14. Guo CH, Chen PC, Ko WS. Status of essential trace minerals and oxidative stress in viral hepatitis C patients with nonalcoholic fatty liver disease. International Journal of Medical Sciences. 2013;10(6):730. DOI: 10.7150/ijms.6104.
15. Mohammed MA, El-dien Abd Elmaksoud MD, Abd El Maksoud N, El-Mezayen HA, El-Garaam H. Serum levels of trace elements in Egyptian patients with chronic hepatitis C under interferon therapy. Journal of Genetic Engineering and Biotechnology. 2012 Jun 1;10(1):81-6. DOI: 10.1016/j.jgeb.2012.03.001.
16. Suda T, Okawa O, Shirahashi R, Tokutomi N, Tamano M. Changes in serum zinc levels in hepatitis C patients before and after treatment with direct-acting antiviral agents. Hepatology Research. 2019 Nov;49(11):1353-6. DOI: 10.1111/hepr.13409.

«Bulletin of problems biology and medicine» Issue 3 (166), 2022 year, 245-249 pages, index UDK 616.36-002.2:577.118

10.29254/2077-4214-2022-3-166-245-249