Effect of zinc on immune recovery in HIV patients. Medellín 2013. Randomized controlled trial

Contreras-Martínez, Heidy; Duque-Molina, Marcela; Vásquez-Trespalacios, Elsa María; Garzón, Juliana Sánchez

doi:10.21615/cesmedicina.31.1.1

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Sample size computation was based on the study by Contreras-Martinez et al, 14 which based its computation on the study by Baum et al, 7 which states that the proportion of immune recovery (increase CD4 cell count) was 76% in the group of patients supplemented with zinc when compared to the placebo group with recovery of 26%. Using these parameters, the estimated sample size is 128 participants (64 per group) with an alpha level of 5% and power of 80%.…”

Section: Methodsmentioning

confidence: 99%

“…According to the UNAIDS (Joint United Nations Programme on HIV and AIDS) global statistics, there are an estimated 1.5 million individuals worldwide newly infected with HIV in 2020. 14 As of May 2019, there were 1,092 newly confirmed HIV-positive individuals reported in the HIV/ AIDS & ART Registry of the Philippines (HARP). 15 Extensive journal search via local database and PubMed, from May 2019 to August 2019, showed that this is the first study to be conducted in the Philippines.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of whole blood zinc levels, CD4 cell count, HIV disease stage, and dermatologic manifestations among diagnosed HIV patients in a tertiary hospital

Sarne¹,

Gabriel²,

Vista³

et al. 2022

International Journal of Dermatology and Venereology

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Objective: Zinc deficiency is the most common micronutrient abnormality seen in human immunodeficiency virus (HIV) infection. Depletion of CD4 cells is a hallmark of HIV infection. The study aims to determine the association between whole blood zinc levels and CD4 cell count and stage of HIV infection among patients in a tertiary hospital in the Philippines. Methods: Sixty-five newly diagnosed HIV-positive patients of the institution were recruited. Demographic profile, whole blood zinc levels, CD4 cell count level, HIV disease stage, and presence of any dermatologic manifestations were noted. Prevalence of zinc deficiency and correlation between whole blood zinc levels and CD4 cell count were determined. The data were analyzed by chi-square and pearson correlation analysis. Results: Among the 65 patients, overall zinc deficiency was noted at 33.8%. Low CD4 count and HIV disease stage IV participants had the highest percentage of zinc deficiency at 54.6% and 50%, respectively. A correlation coefficient at r = 0.3364 was noted between whole blood zinc levels and CD4 cell count (P = 0.006). Twenty-nine patients presented with dermatologic manifestations, with 10 patients being zinc deficient. Conclusion: A weak positive correlation was seen between zinc levels and CD4 count. There is an increasing frequency of zinc level deficiency with a higher HIV disease stage. Dermatologic manifestations of HIV may be present in both patients with normal and deficient zinc levels.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation of whole blood zinc levels, CD4 cell count, HIV disease stage, and dermatologic manifestations among diagnosed HIV patients in a tertiary hospital

Sarne¹,

Gabriel²,

Vista³

et al. 2022

International Journal of Dermatology and Venereology

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Effect of Micronutrients on HIV-Related Clinical Outcomes Among Adults Living With HIV on Antiretroviral Therapy: Systematic Review and Meta-analysis

Okoka,

Kuyebi,

Oyadiran

et al. 2024

Nutrition Reviews

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Context Micronutrient deficiencies are common and frequently co-occurring among people living with HIV (PLHIV) globally, with consequences for their health and clinical outcomes. Previous reviews of the influence of micronutrient supplementation on HIV outcomes were conducted in the pre–highly active antiretroviral therapy (pre-HAART) era or included both HAART-naive and HAART-experienced individuals; thus, the evidence in the context of HAART is inconclusive. Objective A systematic review and meta-analysis was conducted to evaluate the effect of micronutrient supplementation on important clinical outcomes among PLHIV on HAART. Data Sources Original research articles published up to August 2022 in the following medical literature databases were identified and examined: PubMed/Medline, Embase, Web of Science, and Google Scholar. Data Extraction Randomized controlled trials (RCTs) and pre-post intervention studies that evaluated the relationship of micronutrient supplementation and HIV-related outcomes were included. A total of 32 studies investigating the effect of micronutrient supplementation on HIV outcomes in PLHIV on HAART were included. The main outcomes of interest were disease progression, CD4 lymphocyte count, viral load, weight, body mass index (BMI), hemoglobin, and anemia. The Cochrane Risk of Bias (RoB) 2 and ROBINS-I tools were used to assess the risk of bias in included studies, and GRADE was used to assess the certainty of the evidence. Data Analysis Vitamin D supplementation increased serum 25-hydroxyvitamin D concentration by 23.2 nmol/L (95% CI: 11.8 to 34.6; 6 RCTs, 567 participants; low-certainty evidence), but had little to no effect on CD4 lymphocyte counts (mean difference [MD]: 60 cells/µL; 95% CI: −35 to 155; 4 RCTs, 127 participants; low-certainty evidence). The effect of vitamin D on CD4 lymphocyte counts was greater among those with baseline CD4 count <350 cells/µL compared with counterparts with higher CD4 lymphocyte counts. Evidence from single RCTs suggests a beneficial effect of vitamin D on the incidence of sputum-smear–positive tuberculosis (hazard ratio = 0.54; 95% CI: 0.31, 0.92; 4000 participants; low-certainty evidence), and vitamin E (MD = 0.2 g/dL; 95% CI: 0.1, 0.3; 18 participants; moderate-certainty evidence) and selenium (MD = 0.30 g/dL; 95% CI: 0.29, 0.31; 97 participants; high-certainty evidence) on hemoglobin, and selenium on BMI (MD: −0.5; 95% CI: −0.51, −0.49; high-certainty evidence). Zinc supplementation had little to no effect on CD4 lymphocyte count overall, but for every 10-µg/dL higher serum zinc concentration, the predicted change in CD4 lymphocyte count from meta-regression was lower by 28 cells/µL (95% CI: −54, −3; 5 RCTs). Moderate- or high-certainty evidence indicates that there is probably no effect of zinc supplementation on log10 viral load, vitamin D on BMI and lumbar spine bone mineral density, and multiple micronutrient (MMN) supplementation on hemoglobin. The evidence is very uncertain about the effect of zinc supplementation on hemoglobin concentration and BMI, vitamin D supplementation on lumbar spine bone mineral density, vitamin E on CD4 lymphocyte count, and MMN supplementation on CD4 lymphocyte count. Conclusion Zinc and vitamin D supplementation may promote immune recovery in a substantial proportion of PLHIV on HAART, and selenium and vitamin E supplementation may prevent anemia.

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Adjunct Therapy of Zinc Supplementation Increases Immunological Response in HIV-Infected Patients: A Systematic Review and Meta-Analysis

Sindhughosa¹,

Somia²,

Merati³

et al. 2022

TOAIDJ

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Introduction: Malnutrition greatly accelerates the impairment of immune function among HIV-infected patients. Zinc deficiency is often found in people living with HIV/AIDS, affecting their immune function. Several studies have evaluated the effect of zinc in HIV-infected patients, including CD4+ T-cells. However, the results have varied. This review aimed to evaluate the effect of zinc supplementation in HIV patients, particularly its effect on CD4+ T-cells count. Methods: Relevant publications were obtained from PubMed database, Google Scholar, COCHRANE, and Science Direct. The primary outcome was CD4+ T-cells count, while the secondary outcomes were viral load and zinc levels. Year of publication, type of study, population, doses of zinc given, duration of zinc administration, sample size, age, and baseline CD4+ T-cells counts were also obtained and reported. Quantitative data from the publications were analyzed using a fixed-effect model or a random-effect model. Results: We evaluated 13 full-text articles on zinc supplementation in HIV-infected patients, involving 802 subjects for the experiment group and 742 subjects for the control group. Overall, zinc supplementation, whether as zinc supplementation-only or prepared as multiple micronutrient or multivitamin preparation, increases CD4+ T-cells counts by 33.14 cells/mm3 (p =0.02; 95% CI: 6.09 to 60.19), irrespective of age. Subgroup analysis revealed CD4+ T-cells counts also increase in patients who receive zinc supplementation-only preparation by 33.56 cells/mm3 (p = 0.04; 95% CI: 1.5 to 65.63). Zinc supplementation increases serum zinc levels with pooled mean difference of 15.41 µg/dl (p < 0.05; 95% CI: 12.77 to 18.06). However, the viral load did not significantly decrease with zinc supplementation, with a pooled mean difference of -4.02 copies/ml (p =0.7; 95% CI: -24.78 to 16.75), based on the random-effect model. Conclusion: Zinc supplementation in HIV-infected patients enhances immunological response, characterized by an increase in CD4+ T-cells counts. In addition, it increases zinc serum levels in HIV-infected patients, indicating the importance of zinc supplementation in this group of patients.

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Effect of zinc on immune recovery in HIV patients. Medellín 2013. Randomized controlled trial

Cited by 4 publications

References 17 publications

Correlation of whole blood zinc levels, CD4 cell count, HIV disease stage, and dermatologic manifestations among diagnosed HIV patients in a tertiary hospital

Correlation of whole blood zinc levels, CD4 cell count, HIV disease stage, and dermatologic manifestations among diagnosed HIV patients in a tertiary hospital

Effect of Micronutrients on HIV-Related Clinical Outcomes Among Adults Living With HIV on Antiretroviral Therapy: Systematic Review and Meta-analysis

Adjunct Therapy of Zinc Supplementation Increases Immunological Response in HIV-Infected Patients: A Systematic Review and Meta-Analysis

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