Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, United States of America.
Boston University School of Medicine, Boston, Massachusetts, United States of America.
PLoS One. 2019 Jun 27;14(6):e0218852. doi: 10.1371/journal.pone.0218852. eCollection 2019.
Liver disease in people living with HIV co-infected with hepatitis C virus is a source of morbidity and mortality in Russia. HIV accelerates liver fibrosis in the setting of HCV co-infection and alcohol use. Zinc deficiency is common among people living with HIV and may be a factor that facilitates the underlying mechanisms of liver fibrosis. We investigated the association between zinc deficiency and advanced liver fibrosis in a cohort of HIV/HCV co-infected persons reporting heavy drinking in Russia.
This is a secondary data analysis of baseline data from 204 anti-retroviral treatment naïve HIV/HCV co-infected Russians with heavy drinking that were recruited into a clinical trial of zinc supplementation. The primary outcome of interest in this cross-sectional study was advanced liver fibrosis. Zinc deficiency, the main independent variable, was defined as plasma zinc <0.75 mg/L. Exploratory analyses were performed examining continuous zinc levels and fibrosis scores. Analyses were conducted using multivariable regression models adjusted for potential confounders.
The prevalence of advanced liver fibrosis was similar for those with zinc deficiency compared to those with normal zinc levels, (27.7% vs. 23.0%, respectively). We did not detect an association between zinc deficiency and advanced liver fibrosis in the adjusted regression model (aOR: 1.28, 95% CI: 0.62-2.61, p = 0.51) nor in exploratory analyses.
In this cohort of Russians with HIV/HCV co-infection, who are anti-retroviral treatment naïve and have heavy alcohol use, we did not detect an association between zinc deficiency or zinc levels and advanced liver fibrosis.
在合并感染丙型肝炎病毒的艾滋病毒感染者中，肝脏疾病是发病率和死亡率的一个来源。在合并感染丙型肝炎病毒和饮酒的情况下，艾滋病毒会加速肝纤维化。锌缺乏在艾滋病毒感染者中很常见，可能是促进肝纤维化潜在机制的一个因素。我们调查了在报告俄罗斯重度饮酒的艾滋病毒/丙型肝炎病毒合并感染者队列中，锌缺乏与晚期肝纤维化之间的关系。
这是对 204 名抗逆转录病毒治疗初治、重度饮酒的俄罗斯艾滋病毒/丙型肝炎病毒合并感染者的基线数据进行的二次数据分析，这些感染者被招募到一项锌补充剂的临床试验中。本横断面研究的主要观察终点是晚期肝纤维化。锌缺乏是主要的独立变量，定义为血浆锌<0.75mg/L。进行了探索性分析，检查了连续锌水平和纤维化评分。使用多变量回归模型对潜在混杂因素进行了调整，进行了分析。
锌缺乏组和正常锌组的晚期肝纤维化患病率相似（分别为 27.7%和 23.0%）。在调整后的回归模型中（调整比值比：1.28，95%置信区间：0.62-2.61，p=0.51）和探索性分析中均未发现锌缺乏与晚期肝纤维化之间存在关联。
在这个俄罗斯艾滋病毒/丙型肝炎病毒合并感染队列中，这些患者抗逆转录病毒治疗初治且大量饮酒，我们没有发现锌缺乏或锌水平与晚期肝纤维化之间存在关联。
