Zinc Reduces Fibrosis Scores in the Liver and Increases SVR to Triple and Dual DAA s Treatment in Chronic Hepatitis C Patients

The effect of Zinc (Zn) on liver fibrosis and Sustained Viral Response (SVR) of triple therapy (Sofosbuvir, pegylated interferon and ribavirin) and dual (Sofosbuvir and ribavirin) in chronic hepatitis C has not been established. This work aims to evaluate the therapeutic and antifibrotic effect of zinc on triple and dual therapy. Chronic hepatitis C (CHC) patients (N=300) were divided into 4 groups (G) with 75 patients each: G1: Received triple therapy for twelve weeks. G2: Received triple therapy plus oral zinc for twelve weeks. G3: Received dual therapy for twenty four weeks. G4: Received dual therapy plus oral zinc for twenty four weeks. The SVR was 93%, 96%, 83% and 92 % in G1, G2, G3 and G4; respectively. Triple therapy was more effective than dual therapy (p=0.03). The addition of zinc with dual therapy or triple therapy increased SVR than dual therapy without zinc (p=0.05 and p=0.008). Addition of zinc with dual therapy reduces the difference of SVR between G1 and G4 (p=0.772) and between G2 and G4 (p=0.33). The greatest antifibrotic effect was with triple therapy plus oral zinc (26%) the combination of zinc with triple treatment showed the best protection through their synergistic anti-fibrotic effect.