Article Type : Case Report
Authors : Iyevhobu KO
Keywords : Hepatitis; HCV; HBsAg; HBV; Micronutrients
Hepatitis is a condition that affects the liver
and is typically brought on by viral infections, though it can also be brought
on by toxic substances. The three most common viral diseases that cause
hepatitis—a systemic condition that mostly affects the liver—are hepatitis A,
B, and C. In developing countries, hepatitis is a common infection. It is
frequently called infectious hepatitis. Vitamins and trace minerals are
examples of micronutrients that must be ingested in sufficient quantities to
support life and normal physiological function. Worldwide, about 2 billion
people experience deficiencies, which are primarily driven on by hunger or a
subpar diet. A strong immune response against viral infections needs a variety
of micronutrients, yet viruses like the hepatitis B and C viruses also need
them to spread infections. This study was designed as a prospective and
cross-sectional study to evaluate the micronutrients (Iron, Copper, Zinc, and
Magnesium) of hepatitis (HBV and HCV positive) patients in Benin City, Edo
State, Nigeria. Comparisons were made between the outcomes of the biochemical
markers assessed in hepatitis patients and controls. The full medical history
of every subject, including their age, gender, and other significant medical
information, was also obtained from their medical records. Between April 2021
and June 2021, a three-month period, this investigation was carried out. In
order to ensure the veracity of the hepatitis status results, the researcher
further retested both confirmed and negative cases using Hepatitis B and
Hepatitis C test strips in accordance with standard laboratory procedures. A
total of 180 samples was collected from sero-positive Hepatitis B and C
subjects. The mean ± SD of Fe for the control group was 308.79 ± 56.75 while
the test was 508.90 ± 66.65. The mean ± SD of Mg for the control group was 1.97
± 0.25 while the test was 0.69 ± 0.28. The mean ± SD of Zn for the control
group was 0.86 ± 0.13 while the test was 0.80 ± 0.16. The mean ± SD of Cu for
the control group was 128.85 ± 31.31 while the test was 118.05 ± 20.36. There
however for Fe and Mg there was a statistical significance P<0.05 when
compared to the test and control group while for Zn and Cu there was no
statistical significance P>0.05 when compared to the test and control group.
The mean ± SD of Fe for the control group was 308.79 ± 56.75 while the HBV was
520.95 ± 86.62. The mean ± SD of Mg for the control group was 1.97 ± 0.25 while
the HBV was 0.59 ± 0.24. The mean ± SD of Zn for the control group was 0.86 ±
0.13 while the HBV was 0.74 ± 0.18. The mean ± SD of Cu for the control group
was 128.85 ± 31.31 while the HBV was 119.92 ± 23.35. There however for Fe and
Mg there was a statistical significance P<0.05 when compared to the HBV and
control group while for Zn and Cu there was no statistical significance
P>0.05 when compared to the HBV and control group. The mean ± SD of Fe for
the control group was 308.79 ± 56.75 while the HCV was 496.84 ± 35.69. The mean
± SD of Mg for the control group was 1.97 ± 0.25 while the HCV was 0.78 ± 0.28.
The mean ± SD of Zn for the control group was 0.86 ± 0.13 while the HCV was
0.86 ± 0.12. The mean ± SD of Cu for the control group was 128.85 ± 31.31 while
the HCV was 116.18 ± 17.16. There however for Fe and Mg there was a statistical
significance P<0.05 when compared to the HCV and control group while for Zn
and Cu there was no statistical significance P>0.05 when compared to the HCV
and control group.
Micronutrients are vitamins and trace minerals
that we acquire from food and are necessary for maintaining life and proper
physiological function [1,2]. Over 2 billion individuals are affected by
deficiencies, which are primarily linked to malnutrition or a poor diet [3].
Numerous micronutrients are required to trigger an efficient immune response to
viral infections, but viruses like the hepatitis C virus (HCV) and hepatitis B
virus (HBV) also utilise these minerals to spread infections [4]. Essential micronutrients
are engaged in a variety of metabolic processes in the liver, including
enzymatic activities and protein synthesis, oxidative stress and anti-oxidant
defense, immunological competence, interferon therapy response controls, and
modifications of viral genomes [5,6]. In addition, a number of hepatic
illnesses have been linked to reactive oxygen species (ROS) that exacerbate
liver diseases [7,8]. Hepatocellular carcinoma (HCC) is created as a result of
the immune system's response to viral hepatitis and its accompanying oxidant
generation [9]. As a result, the development of viral hepatitis is influenced
by changes in micronutrients and their destructive effects against oxidative
stress. Hepatitis is an illness that affects the liver and is mostly brought on
by viral infections, however toxic chemicals can also cause it. Hepatitis A, B,
and C are the three most frequent viral hepatitis causes. This systemic
condition primarily affects the liver [10]. Hepatitis is a prevalent infection
in poor nations. It is often referred to as infectious hepatitis. Food or water
contamination may produce an outbreak that spreads from person to person and
results in sporadic causes of the hepatitis A virus infection (HAV) [11]. Viral
hepatitis is brought on by five distinct virus types. Hepatitis A, B, C, or E
viruses are the most frequent culprits among these [12,13]. It is a serious
global health issue that is particularly prevalent in South-East Asia and
sub-Saharan Africa. It is a leading source of morbidity and mortality in these
regions [14]. More than a million people die with hepatitis each year, the
majority of them pass away indirectly through liver cancer or scarring [15].
When hepatitis clears up in less than six months, it is considered acute; when
it does not, it is considered chronic [16]. The family Hepadnaviridae includes
the double-stranded DNA virus known as the hepatitis B virus (HBV). The
infection brought on by viruses, drugs, or toxic substances and defined by the
presence of the hepatitis B surface antigen [17]. HBV has an incubation period
of typically four months and is spread through permucosal or percutaneous
exposure to infected body fluids or blood products. It is known that
transmission can happen sexually, parenterally, through blood transfusions and
intravenous drug misuse, horizontally between children in a family, and
vertically from an infected mother to kid [18]. The family Flaviviridae
includes the enveloped, single-stranded RNA virus known as the hepatitis C
virus (HCV). Percutaneous or permucosal exposure to infectious blood or blood
products is how HCV is transmitted. Those who frequently receive blood
transfusions (such as thalassemics), engage in risky sexual behaviour, are
employed in healthcare, and are transplant recipients are among the high risk
groups for HCV infection. According to the above, when the hepatitis virus
attacks the liver severely, acute to chronic hepatitis results. So, after the
attack, there can be a change in the serum proteins. In vertebrates and several
other animals, the liver is an essential organ. It contributes to the creation
of metabolites required for digestion, protein synthesis, and detoxification
[19]. Nearly every organ in the body depends on the liver, which is essential
for living. Liver function tests (LFTs) are used to diagnose various disorders
because of the liver's strategic location and multifaceted functions [20].
However, when one or more of its activities are weakened, such as by hepatitis,
there is a chance that liver disease will develop. Furthermore, because the
liver is crucial for protein synthesis, inflammation of the liver may
potentially have an impact on serum proteins and electrophoretic patterns. A
systemic illness mostly affecting the liver, viral hepatitis [21]. Important
forms of both acute and chronic viral hepatitis include hepatitis B and C.
According to estimates, approximately 2 billion people worldwide exhibit signs
of past HBV and HCV infection; more than 350 million are chronic carriers; and
hepatitis-related disorders are thought to be responsible for over one million
annual deaths. Around 8% of the world's population has HBV infection, and about
5-6% of people are permanent carriers of the disease [22,23]. Therefore, the
presence of a stable virus-host interaction and long-lived, non-dividing host
cells almost guarantees the longevity of an infection in the absence of a
strong immune response [24,25]. A significant human pathogen that causes
cirrhosis, hepatocellular cancer, and acute and chronic hepatitis is the hepatitis
C virus [26]. Acute hepatitis and chronic liver disease are both primarily
brought on by HCV infection [27,28]. Around 686,000 HBV-infected people died
worldwide in 2013 as a result of cirrhosis (317,000 deaths), liver cancer
linked to hepatitis B (300,000 deaths), and acute infection (69,000 deaths)
[29,30]. Hepatitis C-related fatalities were estimated by the Global Burden of
Disease research to have been 333,000 in 1990, 499,000 in 2010, and 704,000 in
2013. There are around 170 million people worldwide who have the hepatitis C
virus (HCV), and there are up to 365 million people who have the hepatitis B
virus (HBV) [31]. One of the main causes of liver illness in Taiwan is hepatic
viral infection, with seroprevalence rates of HBV and HCV estimated to be 17.3%
and 4.4%, respectively [32]. Both HBV and HCV infection have numerous
extrahepatic symptoms, including hematologic, autoimmune, and dermatologic
problems, in addition to liver ailments [33]. The global public health is
seriously threatened by chronic viral hepatitis. The two main viruses that
cause chronic hepatitis are hepatitis B virus (HBV) and hepatitis C virus
(HCV), both of which are known to contribute to the development of cirrhosis
and hepatocellular carcinoma (HCC) [34]. Around 257 million people worldwide
had chronic HBV infection in 2015, according to estimates of the prevalence of
HBV infection in the general population [35]. Around 160 million people are
thought to be chronically infected with HCV, with a 2.4% incidence worldwide
[36]. Understanding the serum biochemical changes will help researchers better
understand how to correlate these parameters with hepatitis progression and
further develop a new strategy for control and management of hepatitis in light
of various reports on the increased mortality and morbidity rate of patients
with hepatitis. As serum proteins and electrophoretic patterns are crucial in
the diagnosis of clinical illnesses such acute and chronic inflammation,
monoclonal gammopathies, nephropathy, and liver diseases, this investigation
will also provide information on any notable changes in the participants with
hepatitis. Few investigations, however, have examined hepatic viral infections
in non-cirrhotic patients who also had osteoporosis and bone loss. We are conducting
this study to assess the micronutrients (Iron, Copper, Zinc, and Magnesium) of
people with hepatitis (HBV and HCV positive) in Benin City, Edo State.
Area of Study
In the Edo State city of Benin, this study was
conducted. Benin City, the capital of southern Nigeria's Edo State, is
estimated to have 1,147,188 residents. Located around 25 miles north of the
Benin River, it is a city. It is located 200 kilometres east of Lagos on the
highway. Nigeria's rubber business is centred in Benin, although processing
palm nuts for oil is a significant traditional sector as well. At 6.34° North
latitude, 5.63° East longitude, and 80 meters above sea level, Benin City is
located [37].
Population of the Study
Population
of study was determined using the formula
N=
Z2pq/d2 [38]
Where N=
the desired sample size (when population is greater than 10,000)
Z= is a
constant given as 1.96 (or more simply at 2.0) which corresponds to the 95%
confidence level.
P=
Prevalence of 13.6% [39].
q= 1.0-p
d= Acceptable
error (5%).
Where N=
sample size, Z=1.96, p=13.6% (0.136) and d=5% (0.05)
N= 1.962
x 0.136 x 0.864/0.052
N=180.56
? 181 subjects.
A minimum
of One Hundred and Eighty (180) samples were obtained and used in this
investigation to account for sampling error or dropouts.
One
hundred and twenty (120) patients with confirmed hepatitis and sixty (60)
subjects who appeared to be in good health (controls) made up the 180
participants in the study (test samples).
Research Design
In order
to assess the micronutrients (Iron, Copper, Zinc, and Magnesium) of hepatitis
(HBV and HCV positive) individuals in Benin City, Edo State, Nigeria, this
study was organized as a prospective and cross-sectional study. Results of the
biochemical parameters measured in hepatitis sufferers were compared to those
in controls. Additionally, each subject's complete medical history (including
age, gender, and other crucial medical data) was gathered from the patient's
medical records. This study was conducted over a three-month period, from April
2021 to June 2021. Additionally, the researcher retested both confirmed and
negative cases using Hepatitis B and Hepatitis C test strips in accordance with
accepted laboratory practices to establish the validity of the hepatitis status
results. Hepatitis and control participants are chosen and grouped for the
study based on this validity. Using the proper statistical techniques, the
study's overall findings were compared to the control.
Ethical Considerations
The Edo State Ministry of Health, located in Benin
City, Edo State, granted ethical approval for this study. Prior to collecting
samples for this investigation, patients' informed consent was also requested
and acquired. The patients were fully informed of the study's objectives and given
assurances regarding the privacy of the data collected from them.
Sample Collection
Each patient had five millilitres (5ml) of venous
blood drawn from the ante-cubital vein using a sterile, disposable syringe. The
serum proteins, total cholesterol, and serum protein electrophoresis were
promptly estimated using the blood samples that were immediately placed in
plain containers. The blood was spun at 5000 rpm for 10 minutes. Using a dry,
clean Pasteur pipette, the serum was separated from the red blood cells and
placed into dry, clean, plain specimen containers. After that, the serum was
kept at -20°C until the samples' analyses.
Qualitative Detection of
Hepatitis B Surface Antigen
The method developed by Deguchi, Yamashita, and Kagita
was used to determine the qualitative detection of Hepatitis B Surface Antigen
[40].
Table
1: Mean
and SD of Fe, Mg, Zn and Cu of normal and Hepatitis infected subjects.
Parameters |
Control |
Test |
t-value |
p-value |
Fe |
308.79
± 56.75 |
508.90
± 66.65 |
-13.287 |
0.000* |
Mg |
1.97 ±
0.25 |
0.69 ±
0.28 |
19.411 |
0.000* |
Zn |
0.86 ±
0.13 |
0.80 ±
0.16 |
1.775 |
0.081 |
Cu |
128.85
± 31.31 |
118.05
± 20.36 |
33.035 |
0.134 |
*: Significant at P<0.05 |
Table
2:
Mean and SD of Fe, Mg, Zn and Cu of normal and Hepatitis B infected subjects.
Parameters |
Control |
HBV |
t-value |
p-value |
Fe |
308.79
± 56.75 |
520.95
± 86.62 |
-10.037 |
0.000* |
Mg |
1.97 ±
0.25 |
0.59 ±
0.24 |
19.074 |
0.000* |
Zn |
0.86 ±
0.13 |
0.74 ±
0.18 |
2.827 |
0.007* |
Cu |
128.85
± 31.31 |
119.92
± 23.35 |
1.120 |
0.269 |
*:
Significant at P<0.05 |
Table
3: Mean
and SD of Fe, Mg, Zn and Cu of normal and Hepatitis C infected subjects.
Parameters |
Control |
HCV |
t-value |
p-value |
Fe |
308.79
± 56.75 |
496.84
± 35.69 |
-13.740 |
0.000* |
Mg |
1.97 ±
0.25 |
0.78 ±
0.28 |
15.188 |
0.000* |
Zn |
0.86 ±
0.13 |
0.86 ±
0.12 |
0.000 |
1.000 |
Cu |
128.85
± 31.31 |
116.18
± 17.16 |
1.738 |
0.091 |
*: Significant at P<0.05 |
Table
4:
ANOVA analysis of Fe, Mg, Zn and Cu of normal and Hepatitis C infected subjects.
Parameters |
Control
|
HBV |
HCV |
t-value |
p-value |
Fe |
308.79
± 56.75 |
520.95
± 86.62 |
496.84
± 35.69 |
80.970 |
0.000* |
Mg |
1.97 ±
0.25 |
0.59 ±
0.24 |
0.78 ±
0.28 |
194.746 |
0.000* |
Zn |
0.86 ±
0.13 |
0.74 ±
0.18 |
0.86 ±
0.12 |
6.003 |
0.004* |
Cu |
128.85
± 31.31 |
119.92
± 23.35 |
116.18
± 17.16 |
1.676 |
0.195 |
*:
Significant at P<0.05 |
Procedure
Before opening the pouch, it was brought to room
temperature. The test Strip was taken out of the sealed pouch as soon as
feasible and used. Each specimen's test strip as well as the control strip were
identified. Until the absorbance occurred without going above the maximum line
(MAX) on the test strip, hold the test strip vertically in the sample with the
arrows pointing toward the specimen. On a flat, non-absorbent surface, test
strips were laid out. Until the red line appeared, the timer was begun (s). At
15 minutes, the verdict was announced. Before reading the results and after 20
minutes, it was made sure that the background was clear. The emergence of two
coloured bands—the control band and the test band—confirmed positive results,
while the appearance of one purplish red band in the control zone indicated a
negative result. When neither the control nor the test bands appeared, the test
was deemed invalid.
Using Wilber's approach, the quality of the Hepatitis
C antibody detection was determined [41].
Procedure
Before opening the pouch, it was brought to room
temperature. The test Strip was taken out of the sealed pouch as soon as
feasible and used. Each specimen's and the control's test strip were recognized.
Until the absorbance occurred without going above the maximum line (MAX) on the
test strip, hold the test strip vertically in the sample with the arrows
pointing toward the specimen. On a flat, non-absorbent surface, test strips
were laid out. Until the red line appeared, the timer was begun (s). At 15
minutes, the verdict was announced. Prior to reading the results, the context
was made clear, and the results were not to be analysed for 20 minutes. The
emergence of two coloured bands—the control band and the test band—confirmed
positive results, while the appearance of one purplish red band in the control
zone indicated a negative result. When neither the control nor the test bands
appeared, the test was deemed invalid.
Serum Iron (?g/dL)
According to Arinola & Akiibinu's
instructions, the amounts of serum ferritin were measured using an atomic
absorption spectrophotometer (AAS) [42].
Procedure
The
Analyst 400 atomic absorption spectrophotometer was used to measure the serum
trace elements via atomic absorption (AAS). The gas (Oxyacetylene) and air pump
were turned on at the same time. Software operations were used to program the
instrument with the parameters and requirements for each of the trace elements
to be studied. The energy lamp was adjusted to 65, the wavelength to 248, 33
nm, the slit to 2.7/1.8, and the current to 15 mA for the study of
iron/ferrtin.
Estimation of Zinc
According to Kaneko's direct approach, the amounts of
zinc must be measured using an atomic absorption spectrophotometer (AAS) [43].
Preparation of Sample
After the samples were thawed, 0.1N HCl was added to
them in a 1:4 dilution to completely breakdown the proteins that the trace
elements were bound to. After that, it was aspirated into the AAS for
examination.
Analytical method
The Analyst 400 atomic absorption spectrophotometer
was used to test the serum's trace components (AAS). Oxyacetylene gas and the
air pump were turned on. Using software manipulations, the instrument's
parameters and requirements for each of the trace elements to be studied were
configured.
The lamp's energy was set to 30, the wavelength to
213.8 nm, the number of slits to 4, and the current to 15 mA for the
examination of zinc. The instrument was then blanked with distilled water
before the flame was kindled. The instrument's probe was then put into each
sample (diluted 1:4). The computer presented the samples and the readings. The
outcomes were shown in mg/l. The value was multiplied by the dilution factor
and then by 100 to convert to g/dl. The measurement is expressed in g/dl.
Calculation
Standard absorbance
Reference range
Serum Zinc: 70 – 150 ?g/dL [44]
Serum Copper (?g/dL)
The Diethyldithiocarbamate technique of Eden & Green,
1940; Ventura & King, 1951 was used to assess the serum copper level.
Procedure
i.
1 mL of 100 mmol/L HCl
was added to 3 ml of serum and heated until the solution turned cloudy.
ii.
Allow to cool for 10
minutes before adding 1.5 mL of 6 mmol/L HCl.
iii. A
little over 3 mL of 200 g/L TCA was added, and the mixture was centrifuged to
separate the supernatant after standing for a little while.
iv. After
washing the precipitate with about 3 mL of 50 g/L TCA, the supernatant liquids
were mixed.
v. Then,
1 mL of sodium diethyldithiocarbamate, 2 mL of ammonia, and 1 mL of sodium
pyrophosphate were added.
vi. To
extract copper, shake the combination of 5 mL amyl alcohol and ether for 2
minutes.
vii. The
organic layer was removed, and anhydrous sodium sulphate was used to dry the
surface.
viii. A
violet filter was used to read the absorbance (440 nm).
Serum Magnesium (?g/dL)
In
Practical Clinical Biochemistry, the diethyldithiocarbamate method of Eden and
Green (1940) and Ventura and King (1951) was used to assess the magnesium
levels in serum [45].
Procedure
i.
1 mL of 100 mmol/L HCl was added to 3 ml
of serum and heated until the solution turned cloudy.
ii.
Allow to cool for 10 minutes before adding
1.5 mL of 6 mmol/L HCl.
iii.
A little over 3 mL of 200 g/L TCA was
added, and the mixture was centrifuged to separate the supernatant after
standing for a little while.
iv.
After washing the precipitate with about 3
mL of 50 g/L TCA, the supernatant liquids were mixed.
v.
Then, 1 mL of sodium
diethyldithiocarbamate, 2 mL of ammonia, and 1 mL of sodium pyrophosphate were
added.
vi.
To extract copper, shake the combination
of 5 mL amyl alcohol and ether for 2 minutes.
vii.
The organic layer was eliminated, and
anhydrous sodium sulphate was used to dry the surface.
viii. A
violet filter was used to read the absorbance (440 nm).
Statistical Analysis
The collected results' mean and standard deviation
were computed. The study was conducted using SPSS program version 21 and ANOVA
(LSD). In this investigation, values with p 0.05 were deemed statistically
significant.
Shows the Mean and SD of
Fe, Mg, Zn and Cu of normal and Hepatitis infected subjects
From individuals with seropositive hepatitis B and c,
180 samples were taken. The test group had a mean and SD of 508.90 66.65 while
the control group's was 308.79 56.75. The test had a Mg mean and SD of 0.69
while the control group's was 1.97 and 0.25. Zn's mean SD for the control group
was 0.86 0.13 whereas it was 0.80 0.16 for the test group. The control group's
mean and standard deviation for Cu was 128.85 31.31, whereas the test group's
was 118.05 20.36. In contrast, there was no statistical significance P>0.05
for Zn and Cu when compared to the test and control group, but there was for Fe
and Mg when compared to the test and control group (Table 1).
Shows Mean and SD of Fe,
Mg, Zn and Cu of normal and Hepatitis B infected subjects
The HBV was 520.95 86.62 while the mean SD of Fe for
the control group was 308.79 56.75. While the HBV was 0.59 0.24, the mean SD of
Mg for the control group was 1.97 0.25. While HBV was 0.74 0.18, the mean SD of
Zn for the control group was 0.86 0.13. In the control group, the mean SD of Cu
was 128.85 31.31 while in the HBV group, it was 119.92 23.35. However, there
was no statistical significance P>0.05 for Zn and Cu when compared to the
HBV and control group, whereas there was for Fe and Mg when compared to the HBV
and control group (Table 2).
Shows Mean and SD of Fe,
Mg, Zn and Cu of normal and Hepatitis C infected subjects
The HCV group's mean SD of Fe was 496.84 35.69,
whereas the control group's was 308.79 56.75. For the control group, the mean
SD of Mg was 1.97 0.25, while for the HCV, it was 0.78 0.28. Zn's mean SD for
the control group was 0.86 0.13, while it was 0.86 0.12 for the HCV group. Cu
mean SD for the control group was 128.85 31.31 while it was 116.18 17.16 for
the HCV group. However, there was no statistical significance P>0.05 for Zn
and Cu when compared to the HCV and control group, whereas there was for Fe and
Mg when compared to the HCV and control group (Table 3).
ANOVA analysis of Fe, Mg,
Zn and Cu of normal and Hepatitis C infected subjects
The HBV was 520.95
86.62, the HCV was 496.84 35.69, and the mean SD of Fe for the control group
was 308.79 56.75. For the control group, the mean SD of Mg was 1.97 0.25, HBV
was 0.59 0.24, and HCV was 0.78 0.28. The control group's mean and standard
deviation for Zn was 0.86 0.13, for HBV it was 0.74 0.18, and for HCV it was
0.86 0.12. The mean and standard deviation (SD) of Cu for the control group
were 128.85 31.31, 119.92 23.35 for HBV, and 116.18 17.16 for HCV. When Zn and
Cu were compared throughout the table, there was no statistical significance
P>0.05, but when Fe and Mg were, there was a statistical significance P0.05
(Table 4).
The findings of this
study indicate that the HBV was 520.95 86.62, the HCV was 496.84 35.69, and the
mean SD of Fe for the control group was 308.79 56.75. For the control group,
the mean SD of Mg was 1.97 0.25, HBV was 0.59 0.24, and HCV was 0.78 0.28. The
control group's mean and standard deviation for Zn was 0.86 0.13, for HBV it
was 0.74 0.18, and for HCV it was 0.86 0.12. The mean and standard deviation
(SD) of Cu for the control group were 128.85 31.31, 119.92 23.35 for HBV, and
116.18 17.16 for HCV. However, when compared
throughout the table, there was no statistical significance P>0.05 for Cu,
although there was for Fe, Mg, and Zn. Additionally, it was discovered that Fe,
Mg, and Zn had significant (P<0.05) increases, whereas Mg and Zn had
decreases. This result supported the findings of which found that Zn is
involved in the activation of PPAR-, a regulator of lipid homeostasis. Zn might
take involvement in PPAR-'s ability to bind DNA. Therefore, Zn shortage may
lead to a decrease in PPAR- activity, which in turn may promote lipid
peroxidation and, ultimately, worsen hepatic steatosis [46].
According to the criteria for hepatic steatosis for patients with HCV-related
CLD, observed that the serum Zn levels of patients steadily declined as their
hepatic steatosis progressed from a mild status to a severe status [47].
The outcome for Fe was
consistent with the findings of who reported that when transgenic mice
expressing the HCV polyprotein were fed an excessive Fe diet, the unfold
protein response was activated, leading to the development of hepatic steatosis
[48].
Therefore, his research proved that in HCV-related individuals, blood ferritin
levels increased in proportion to the severity of hepatic steatosis. NAFLD
sufferers frequently had lower serum Cu levels [49]. As no discernible alterations were found,
this was also in contrast to our study. Cu availability is probably going to
lead to fatter build-up in the liver. Therefore,
decreased Cu bioavailability may impact lipid metabolism and contribute to the
emergence of NAFLD.
In conclusion, with the exception of Cu, HBV and HCV
considerably altered Fe, Zn, and Mg. However, there is still much to learn
about this phenomenon. More research on the impact of HBV and HCV on
micronutrients is needed because it will enlighten the medical community. Additionally,
those who have HBV or HCV should always follow a healthy diet.
The
authors say they have no competing interests. The paper's writing and content
are solely the authors' responsibility.
Public, private, or
non-profit funding organizations did not provide any grants for this research.
The authors appreciate the great help from the
laboratory and technical team at St Kenny Research Consult in Edo State, who
also provided medical writing and editing support in compliance with GPP3
standards.