Department of Pharmacy, Kobe Asahi Hospital, 3-5-25, Bououji-cho, Nagata-ku, Kobe Hyogo, 653-0801, Japan,
Hepatol Int. 2008 Mar;2(1):111-5. doi: 10.1007/s12072-007-9029-y. Epub 2008 Jan 11.
Zinc has been reported to ameliorate hematologic side effects and improve liver function. In addition to its various effects, zinc supplementation in chronic hepatitis C patients with genotype 1b of high viral load enhanced the response to interferon (IFN) monotherapy. This study was aimed at clarifying whether zinc could improve hematologic side effects, improve liver function, and enhance the response to therapy in patients with chronic hepatitis C treated with pegylated-interferon (PEG-IFN) plus ribavirin (RBV).
The 32 patients enrolled in the study were randomly divided into two groups: a PEG-IFN-alpha2b plus RBV with zinc group (PEG/RBV + zinc, n = 16) and a PEG-IFN-alpha2b plus RBV group (PEG/RBV, n = 16). HCV-RNA, serum zinc, ALT, white blood cell, red blood cell, platelet, and hemoglobin (Hb) levels were examined.
Serum zinc levels were significantly higher in the PEG/RBV with zinc group than in the PEG/RBV without zinc group at 4, 8, and 12 weeks. No significant differences were observed in the clearance of HCV-RNA between the two groups. The outcome of the treatment was similar; results of laboratory examinations including ALT before, during, and after therapy revealed no significant differences between the two groups at any point in all items except serum zinc levels. A sustained virological response rate was observed in 50.0% in the PEG/RBV with zinc group and 43.8% in the PEG/RBV without zinc group, with no significant difference between the two groups.
The study demonstrated no evidence that zinc ameliorates hematologic side effects, improves liver function, and enhances the response to the therapy in chronic hepatitis C receiving PEG-IFN-alpha2b plus RBV.
锌已被报道可改善血液学副作用并改善肝功能。除了其各种作用外,补充锌还可以增强高病毒载量 1b 基因型慢性丙型肝炎患者对干扰素(IFN)单药治疗的反应。本研究旨在阐明锌是否可以改善慢性丙型肝炎患者接受聚乙二醇干扰素(PEG-IFN)联合利巴韦林(RBV)治疗的血液学副作用,改善肝功能并增强治疗反应。
该研究纳入的 32 名患者被随机分为两组:PEG-IFN-α2b 联合 RBV 加锌组(PEG/RBV+锌,n=16)和 PEG-IFN-α2b 联合 RBV 组(PEG/RBV,n=16)。检测 HCV-RNA、血清锌、ALT、白细胞、红细胞、血小板和血红蛋白(Hb)水平。
在第 4、8 和 12 周时,PEG/RBV+锌组的血清锌水平明显高于 PEG/RBV 无锌组。两组之间 HCV-RNA 的清除率无显著差异。治疗结果相似;包括治疗前、治疗中和治疗后的 ALT 在内的实验室检查结果显示,除血清锌水平外,两组在所有项目中均无显著差异。PEG/RBV+锌组的持续病毒学应答率为 50.0%,PEG/RBV 无锌组为 43.8%,两组间无显著差异。
本研究表明,在接受 PEG-IFN-α2b 联合 RBV 治疗的慢性丙型肝炎患者中,锌不能改善血液学副作用,改善肝功能并增强治疗反应。