Zinc deficiency and advanced liver fibrosis among HIV and hepatitis C co-infected anti-retroviral naïve persons with alcohol use in Russia

PLoS One. 2019 Jun 27;14(6):e0218852. doi: 10.1371/journal.pone.0218852. eCollection 2019.


Background and aims: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / blood
  • Cohort Studies
  • Coinfection
  • Cross-Sectional Studies
  • Female
  • HIV Infections / blood
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / epidemiology
  • Humans
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / etiology*
  • Liver Cirrhosis, Alcoholic / blood
  • Liver Cirrhosis, Alcoholic / epidemiology
  • Liver Cirrhosis, Alcoholic / etiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Russia / epidemiology
  • Young Adult
  • Zinc / blood
  • Zinc / deficiency*


  • Zinc