Investigation of Serum Nitric Oxide, Zinc, Copper, and C-Reactive Protein Levels in Acute Hepatitis B Patients

Acute hepatitis B (AHB) infection impacts millions globally, causing severe liver disease. This study aimed to assess serum nitric oxide (NO), C-reactive protein (CRP), copper (Cu), and zinc (Zn) levels and their interrelationships in AHB pathogenesis. We investigated these biomarkers in 58 patients with AHB and 30 healthy controls. Results showed that patients with AHB had significantly higher serum levels of NO metabolites, CRP, and Cu, while Zn concentrations were significantly lower compared to the control group (p < 0.001 for all). A distinct biomarker profile emerged from correlation analysis: strong positive correlations were found among the pro-inflammatory markers, with CRP levels showing a significant positive association with both Cu (rho = 0.677) and total NO metabolites (rho = 0.631). Conversely, serum Zn levels exhibited a consistent and significant negative correlation with all other measured markers, most notably with CRP (rho =  - 0.649) and Cu (rho =  - 0.520). These findings highlight a coordinated inflammatory response in AHB, characterized by elevated pro-inflammatory mediators and a concurrent depletion of the essential trace element zinc. This interconnected biomarker panel underscores a significant pathophysiological network and holds potential as a composite tool for the diagnosis and management of AHB.