Oral Zinc Supplementation in Chronically HEV-Infected Patients Not Responding to Ribavirin Monotherapy

Background: Chronic hepatitis E virus (HEV) infection may progress to end-stage liver disease in immunosuppressed individuals. Ribavirin therapy is efficient most chronic HEV patients, but 10% remain without a sustained virological response (SVR). Objectives: We aimed study whether zinc supplementation could represent therapeutic approach these patients. Methods: Antiviral properties of salts were studied vitro (subgenomic-replicon system), vivo (rabbit model), and retrospectively patients with who did not achieve SVR under ribavirin monotherapy. Results: Zinc inhibited genotype 3 replication vitro. In model acute immunocompetent rabbits, + improve viral clearance compared chronically HEV-infected responding (n = 12), was observed 4/12 (33%) receiving additional supplementation. Conclusions: Oral zinc, an inexpensive, harmless dietary supplement, potentially rescue treatment option for few Further studies are needed elucidate the role HEV.