Serum zinc status in chronic hepatitis B and its relationship to liver histology and treatment results.
BACKGROUND
It is known that cytotoxic T lymphocytes are responsible for viral clearance in chronic hepatitis B (HBV) infection. Zinc deficiency affects development of acquired immunity by preventing certain functions of T lymphocytes. We investigated the serum zinc levels and the relationship to liver histopathology and response to interferon alpha (IFN-alpha) and lamivudine combination therapy in 28 children with chronic HBV infection.


METHODS
A course of IFN-alpha was injected as 5 million U/m2 subcutaneously, thrice a week for 6 months and lamivudine 4 mg/kg per day orally, for 1 year. Normalization of alanine aminotransferase (ALT), loss of HBV DNA, hepatitis B e antigen (HBeAg) seroconversion altogether was considered as end of therapy response (ETR).


RESULTS
The ETR was achieved in eight (30.7%) patients. Serum zinc concentrations of 20 healthy children and patients was not significantly different (P>0.05). While pretreatment serum ALT, zinc, histological activity index (HAI) and portal inflammation scores were statistically higher in children who had ETR (P<0.005, P<0.05, P<0.05 and P<0.05, respectively), pretreatment serum HBV DNA was lower (P<0.005). Serum zinc level was correlated with HAI and portal inflammation scores (P<0.01 and P<0.01).


CONCLUSIONS
This study showed the relationship of serum zinc status to liver histopathology and to the ETR and may be a preliminary study leading new studies focusing on zinc status in patients with chronic HBV infection.
Selimoglu
M A
MA
Gastroenterology and Nutrition Unit, Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey. ayseselimoglu@hotmail.com
Aydogdu
S
S
Unal
F
F
Yüce
G
G
Yagci
R V
RV
D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D006509:Hepatitis B / Q000235:genetics; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D015032:Zinc / Q000097:blood*
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000410:Alanine Transaminase; D015032:Zinc