ZINC LEVELS AND INFECTIONS IN HOSPITALIZED-PATIENTS WITH AIDS

Impaired cellular and humoral immunity and phagocytic function have be en attributed to zinc deficiency. This study examined the association between low serum zinc concentration and opportunistic infections in h ospitalized patients with the acquired immune deficiency syndrome(AIDS ). We examined the records from all 505 inpatient consultations perfor med by our Nutrition Service from May 1992 through June 1994. The medi cal records from all 228 patients with AIDS with known serum zinc leve ls (determined by atomic absorption spectrophotometry) were reviewed. The length of HIV seropositivity, most recent CD4 count, presence of-d iarrhea, and degree of malnutrition were noted. The principal diagnosi s accounting for the admission was grouped according to the type of in fection: Pneumocystis carinii pneumonia (PCP), viral, fungal, bacteria l, and other. Sixty-seven patients (29%) had abnormally low serum zinc levels (LSZ < 55 mu g/dL), 49 patients (21%) had borderline low serum zinc (BSZ greater than or equal to 55 and less than or equal to 65 mu g/dL), and 112 (49%) patients had normal serum zinc levels (NSZ > 65 mu g/dL). There was no significant difference among the groups in CD4 count, length of HIV seropositivity, presence of diarrhea, or severity of malnutrition. Patients with zinc deficiency (LSZ) had a significan tly higher incidence of bacterial infection than did patients with nor mal zinc. Patients with borderline zinc levels had an intermediate inc idence of bacterial infection. There were no significant differences a mong the three groups in the incidence of PCP, viral, or fungal infect ions. Severe zinc deficiency was noted in 29% and borderline levels in an additional 21% of hospitalized AIDS patients. A low zinc level was not associated with the length of HN seropositivity, CD4 count, or de gree of malnutrition. Hypozincemia was associated with an increased in cidence of concomitant systemic bacterial infections.