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Zinc Benefits HIV-Positive Children

December 5, 2005

Zinc supplements may offer a safe means of reducing the incidence of diarrhea in children with HIV, according to a new study.

The study by American and South African researchers was published in the 26 November issue of The Lancet and reported by Reuters on 25 November 2005.

Controversy has surrounded the use of Zinc in people with HIV: Although zinc is an essential mineral for assuring healthy development and maintaining a strong immune system, zinc is also an essential mineral for HIV virus function and replication.

Approximately 40.3 million people worldwide, including about 2.3 million children under age 15 years, are living with HIV, according to the recent figures from UNAIDS, the UN agency that advocates for global action on HIV/AIDS.

About 570,000 children died from AIDS in 2005, according to UNAIDS.

Clinical Study

In this randomized, double-blind, placebo-controlled study, researchers studied the effect of zinc supplements in 96 children. Participants were children with HIV-1 infection and were randomly assigned to receive elemental zinc (10 mg) as sulfate or placebo daily for a period of 6 months.

At baseline, researchers measured plasma HIV-1 viral load and the percentage of CD4+ T lymphocytes, repeating measurements at 3, 6, and 9 months after supplementation began.

The study's primary outcome measure was plasma HIV-1 viral load.

The mean HIV-1 viral load after 6 months was similar between the two groups, as were the mean percentage of CD4+ T lymphocytes and median hemoglobin concentrations.

Two deaths occurred in the zinc supplementation group and seven in the placebo group (p=0.1).

Children who received zinc supplementation were less likely to get watery diarrhea than those given placebo.

Results

The researchers concluded that "zinc supplementation of HIV-1-infected children does not result in an increase in plasma HIV-1 viral load and could reduce morbidity caused by diarrhea."

Based on these results, researchers Bobat et al concluded that zinc supplementation is safe for children with HIV, whose weakening effect on the immune system increases patients' vulnerability to infection and illness.

"Zinc supplementation could be a simple and cost-effective intervention to reduce morbidity and mortality in children with HIV infection," said Dr William Moss, of Johns Hopkins School of Public Health in Baltimore, Maryland, according to Reuters.

The need for a safe supplement for treating people with HIV in poor countries is critical. Although the World Health Organization (WHO) has increased poorer countries' access to antiretroviral drugs, Moss reported to Reuters that these treatments are often not available for children.

"Consequently more than half of these children die before the age of 3 years, most commonly of respiratory tract infections and diarrheal disease," Moss reported to Reuters. "Programs to enhance zinc intake in deficient populations with a high prevalence of HIV infection can be implemented without concern for adverse effects on virus replication."

Source:
HIV children benefit from zinc: study, Reuters, 25 November 2005.
Safety and efficacy of zinc supplementation for children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial. Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE, Moss WJ, The Lancet, volume 366(9500), pages 1862-1867, 26 November 2005.

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