Previous studies have shown that zinc supplements can reduce the incidence of diarrhoea and pneumonia in children in resource-poor settings. However, the HIV virus requires zinc for its structure and function, and zinc activates lymphocytes that are target cells for HIV-1 replication. For these reasons the safety of zinc supplementation in children with HIV-infection has been uncertain.
To study the affect of zinc supplementation, William Moss (Johns Hopkins School of Public Health, Baltimore, MD, USA) and colleagues recruited 96 children, aged between 6 months and 5 years, from Grey's Hospital in Pietermaritzburg, South Africa. The team randomly assigned children to receive zinc supplements or a placebo daily for 6 months. The investigators found that zinc supplementation did not result in an increase in blood HIV viral load. However, children receiving zinc had less diarrhoea. The authors state that zinc supplementation should be used as an adjunct therapy for children with HIV-1 infection.
Dr Moss states: "Few interventions are available to reduce morbidity in children with HIV-1 infection in resource-poor countries. Although UNAIDS, WHO, and their partners are committed to providing antiretroviral therapy to 3 million people by the end of 2005, antiretroviral therapy and prophylaxis for opportunistic infections are not accessible for many children. Consequently, more than half these children die before the age of 3 years, most commonly of respiratory tract infections and diarrhoeal diseases…Zinc supplementation could be a simple and cost-effective intervention to reduce morbidity and mortality in children with HIV-1 infection…Programmes to enhance zinc intake in deficient populations with a high prevalence of HIV-1 infection can be implemented without concern for adverse effects on virus replication."
Contact: Dr William Moss via Kenna Lowe or Tim Parsons T) 410-955-6878 or paffairs@jhsph.edu
Journal
The Lancet