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Participants were randomly assigned to two groups: Group 1 (Control group, <jats:italic>n<\/jats:italic>\u2009=\u200925) received standard direct-acting antiviral therapy for 3\u00a0months, while Group 2 (Zinc group, <jats:italic>n<\/jats:italic>\u2009=\u200925) received 50\u00a0mg\/day of zinc sulfate in addition to the standard direct-acting antiviral therapy for the same duration. Baseline and 3-month post-intervention assessments included evaluating serum levels of hyaluronic acid, transforming growth factor beta-1, and fibronectin. Furthermore, indices of liver fibrosis, such as the Fibrosis Index based on the 4 factors (FIB-4) and the Aspartate Transaminase-to-Platelet-Ratio Index (APRI), were calculated during these assessments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At baseline, the two studied groups had no statistical difference in demographic and laboratory data. After treatment, serum zinc levels significantly increased in the zinc-treated group compared to the control group. Additionally, serum fibronectin and hyaluronic acid levels were significantly reduced in group 2 (zinc group) compared to group 1 (control group). Moreover, zinc group showed lower APRI scores than the control group after a 3-month follow-up period, but there was non-significant difference in FIB-4 scores between the two groups after treatment. Furthermore, total bilirubin levels were reduced after zinc therapy for 3\u00a0months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Administering zinc sulfate could potentially serve as a safe and efficient therapeutic strategy for the management of hepatic fibrosis in individuals with chronic hepatitis C virus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial Registration<\/jats:title>\n            <jats:p>ClinicalTrials.gov identifier: NCT05465434, On 19\/7\/2022.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10787-024-01628-3","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T17:42:50Z","timestamp":1736444570000},"page":"329-339","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A randomized clinical study to evaluate the possible antifibrotic effect of zinc sulfate in chronic HCV patient receiving direct-acting anti-viral therapy"],"prefix":"10.1007","volume":"33","clinical-trial-number":[{"clinical-trial-number":"nct05465434","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Sahar M.","family":"El-Haggar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6196-5295","authenticated-orcid":false,"given":"Dina S.","family":"Attalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Elhelbawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalia R.","family":"El-Afify","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"1628_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.671640","volume":"12","author":"P Acharya","year":"2021","unstructured":"Acharya P, Chouhan K, Weiskirchen S, Weiskirchen R (2021) Cellular mechanisms of liver fibrosis. 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Approval was granted by The Research Ethics Committee of Tanta University and the protocol was given the number: 35606\/2022. National Liver Institute Institutional Review Board (NLI IRB) protocol number: 00310\/2022. Name of the IRB and reference number: NLI IRB 00003413.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The patients were enrolled between August 2022 and September 2023 from the Hepatitis C Unit at the National Liver Institute of Institutional University Hospital in Shebin El-Kom, Menoufia Governorate, Egypt, Written informed consent had obtained from all participants before their inclusion in this research. Monthly in-person visits were used to follow up with patients, with additional weekly phone calls to ensure that study medications were used correctly, assess compliance, and quickly handle any adverse drug reactions. Tablet counting and medication refill rates were used to measure adherence to the trial medication. Nonadherence was defined as any instance of underuse, overuse, or discontinuation of the study medications by the patient.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not Applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}