Evaluation of Serum Zinc Level in Egyptian Patients with Hepatitis C-associated Cirrhosis

Nahla H. Anber; Magdy Z. El-Ghannam; Gamal A. El-Kheshen; Mahmoud I. Bialy

Evaluation of Serum Zinc Level in Egyptian Patients with Hepatitis C-associated Cirrhosis

Nahla H. Anber, Magdy Z. El-Ghannam, Gamal A. El-Kheshen, Mahmoud I. Bialy

Abstract

Hepatitis C viral infection is a common health problem in Egypt. The complications of HCV include cirrhosis and hepatocellular carcinoma. Zinc is a micronutrient that plays role in immune system and antioxidant system. Zinc is thought to be associated with HCV-related hepatic complications.
The aim of the present study was to evaluate the level of serum zinc in patients with different stages of hepatitis C associated liver cirrhosis and HCC.
This cross-sectional study was carried out in 75 patients with various stages of HCVassociated liver affections. They included 25 early cirrhotic patients on top of HCV with positive U/S and laboratory tests for cirrhosis with positive viral markers for HCV, 25 patients with advanced cirrhosis on top of HCV and 25 patients with primary hepatocellular carcinoma on top of HCV with a positive U/S and triphasic CT for malignant focal lesions with positive viral markers for HCV. In addition, 25 healthy subjects were recruited as a control group. Blood samples were obtained from each subject a subjected for full laboratory studies for biochemical liver functions tests, prothrombin time and Zinc
determination.
There were statistically significant differences in late cirrhosis, HCC and control groups regarding albumin (ALB) and total bilirubin (T. Bil) (P < 0.001). Prothrombin time had statistically significant prolonged time (P < 0.001) in early cirrhotic group, 14.75 ± 0.75 seconds, late cirrhotic group was 16.7 ± 2.2 seconds and in HCC group was 17.5 ± 0.9 seconds than the standard value of prothrombin time (11–13 seconds) and INR (0.9–1.1). There were statistically significant (P < 0.001) differences between early cirrhosis (103.8 ± 9.7) and control groups (122.4 ± 7.1) as regard to serum zinc. There were statistically significant differences (P < 0.001) between late cirrhosis (94.0 ± 12.7), CC (94.0 ± 12.7) and control groups (122.4 ± 7.1) with regard to serum zinc. There were insignificant correlations between ALT, AST, bilirubin, albumin and serum zinc level.
From the present study we can conclude that serum zinc level decreases significantly in chronic HCV infection with liver cirrhosis and hepatocellular carcinoma. The decrease of serum zinc can be used as a laboratory parameter for evaluation of liver status in cases of liver dysfunction on top of HCV. It is recommended to evaluate the role of zinc supplementation in treating clinical manifestation of liver cirrhosis and liver cell failure associated with HCV.

Keywords

HCV, HCC, liver cirrhosis, zinc

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