ORAL ZINC SUPPLEMENTATION IN THE TREATMENT OF HIV-INFECTED CHILDREN

Primary zinc (Zn) deficiency has been reported to cause immune dysfunc tion; secondary Zn deficiency has been noted in HIV-infected adults; a nd in vitro studies have suggested that Zn may have antiviral activity . Zn supplementation was studied in HIV-infected children to evaluate selected clinical and laboratory responses. Thirteen clinically stable HIV-infected children (five females, eight males, 1.5-10 years of age , mean 6 years) with CD4(+) counts < 500/mm(3) were supplemented with oral elemental zinc at 1.8-2.2 mg/kg/day for 3 to 4 weeks. HIV p24 ant igen (p24) levels, T-cell subsets, and serum Zn and copper (Cu) levels were measured before and at the end of Zn supplementation. Clinical a ssessment of appetite, sense of well being, weight change, and days of fever over 38 degrees C was performed at these times. Baseline serum Zn levels were abnormally low in nine (69%) HIV-infected children. Aft er oral elemental Zn supplementation, six had increased their serum Zn level into the normal range. However, only two patients had increased CD4(+) T-cell numbers and none of the seven patients with positive p2 4 had decreased p24 levels. Clinical scores improved in only four pati ents. This study does not demonstrate impressive shortterm benefit fro m oral Zn supplementation in HIV-infected children.