Contribution of zinc to reduce CD4(+) risk factor for 'severe' infection relapse in aging: parallelism with HIV

Aging and HIV have parallelism in immunodeficiency status because of the ap pearance of infections or relapse leading to death in both conditions. HIV- RNA is predictor for HIV progression correlated with CD4(+) depletion. CD4( +) and plasma zinc levels (zincaemia) may be predictors for infections rela pse in aging because of zinc relevance for normal immune efficiency against infections and for CD4(+) growth. Moreover, zincaemia decreases in aging a nd infection. A total of 67 elderly subjects affected by infections resista nt to antibiotic therapy were recruited. A total of 28 HIV+ subjects with H AART therapy were also used. CD4(+) depletion (507 mm(3)) and zincaemia def iciency (76 mu g/dl), as compared to CD4(+) (700-1100 mm(3)) and zincaemia (85-100 mu g/dl; age 40-75 years) normal ranges, are possible limits (Cox h azard regression) for severe infections relapse, such as chronic obstructiv e bronchitis and bronchopneumonia by bacteria or Candida complication, in a ging. CD4(+) and zincaemia values are within the lower limits of normal ran ge in urinary tract infections. Zincaemia and HIV-RNA or CD4(+) are inverse ly correlated (r = 0.57 and r = 0.72, respectively) in HIV+ HAART treated s ubjects. Consequently there is no appearance of opportunistic infections. P arallelism between aging and HIV may exist because of the resemblance in ma rked zinc deficiency and CD4(+) depletion with high scores in relative risk s for severe infections relapse. Supplementing zinc (12 mg Zn++/day) for on e month in infected elderly subjects and HAART therapy in HIV+ subjects red uces risk scores in CD4+ and zincaemia deficiencies for infections relapse, suggesting that the zinc beneficial effect may be independent either by HI V-virus or pathogen agents involved. While HAART may reduce the occurrence of opportunistic infections in HIV by means of also major zinc bioavailabil ity, supplementing zinc can be recommended in elderly people as resistence to infections. Since zinc deficiency is correlated with CD4(+) depletion, t his latter may also be good diagnostic marker to detect "clear immunodefice ncy" in aging, as in HIV condition. (C) 1999 International Society for Immu nopharmacology. Published by Elsevier Science Ltd. All rights reserved.