Zinc supplementation enhances the response to interferon therapy

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Journal of Viral Hepatitis 8 (5), 367-371 © Blackwell Science Ltd

Zinc supplementation enhances the response to interferon therapy in

patients with chronic hepatitis C

Takagi, Nagamine, Abe, Takayama, Sato, Otsuka, Kakizaki, Hashimoto,

Matsumoto, Kojima, Takezawa, Suzuki, Sato and Mori

1 The First Department of Internal Medicine, Gunma University School

of Medicine, Maebashi, Gunma, Japan2 Department of Nursing, Gunma

University, Faculty of Medicine, School of Health Science, Maebashi,

Gunma, Japan3 Department of Laboratory Science, Gunma University,

Faculty of Medicine, School of Health Science, Maebashi, Gunma,

Japan4 Vice President of Iwate Medical University, Morioka, Japan

We evaluated the synergistic effect of zinc supplementation on the

response to interferon (IFN) therapy in patients with intractable

chronic hepatitis C in a pilot study using natural IFN-a with or

without zinc. No clinical differences were observed between patients

treated with IFN alone (n=40) and IFN with polaprezinc (IFN + Zn,

n=35). All patients were positive for HCV genotype Ib and had more

than 105 copies of the virus/mL serum. Ten million units of natural

IFN-a was administered daily for 4 weeks followed by the same dose

every other day for 20 weeks. In the IFN + Zn group, patients

received an additional dose of 150 mg/day polaprezinc orally

throughout the 24-week IFN course. No additional side-effects of

polaprezinc were noted but four out of 40 IFN alone treatment and

three out of 35 IFN + Zn group withdrew because of side-effects.

Complete response (CR) was defined as negative HCV RNA in the serum

on PCR and normal aminotransferase level 6 months after therapy.

Incomplete response (IR) was normal liver enzyme and positive serum

HCV RNA. Both of them were evaluated at the 6 months after the

completion of the treatment. Patients with higher levels of serum HCV

(more than 5 × 105 copies/mL) had little response in both treatment

groups. Patients with moderate amount of HCV (105 to 4.99 × 105/mL)

showed high response rates in combination group (CR: 11/27, 40.7%; CR

+ IR 15/27, 64.3%), better than IFN alone (CR: 2/15, 18.2%; CR + IR:

2/15, 18.2%). Serum zinc levels were higher in patients with IFN + Zn

group than in the IFN group. Our results indicate that zinc

supplementation enhances the response to interferon therapy in

patients with intractable chronic hepatitis C.