Brief Report: Randomized Controlled Trial of Zinc Supplementation for Persistent Diarrhea in Adults With HIV-1 Infection

Abstract

Supplemental zinc had no significant effect on the duration or remission of diarrhea in HIV-infected adults.

Nutrition Therapy for HAART-Naïve HIV-Infected Patients

“…In malnourished individuals, or in areas of known food insecurity, supplementation should be beyond the levels of the RDA to correct the deficiencies, given that lower doses may not have the desired effect. In a study in which 55% of the sample had severe zinc deficiency at baseline, supplementation of 50 mg of zinc twice daily for 14 days in adults did not reduce diarrhea when compared with the control group [37].…”

Serum Zinc Concentration and C-Reactive Protein in Individuals with Human Immunodeficiency Virus Infection: the Positive Living with HIV (POLH) Study

“…Low plasma zinc concentrations are frequently reported in patients with HIV [8][9][10][11][12][13] even among those who are under antiretroviral therapy (ART) [14][15][16][17][18]. The reported prevalence of zinc deficiency varies between 30 and 51 % among HIV-infected adult population [19][20][21]. Zinc deficiency alters cellular immunity, reducing the generation of T cells and depresses humoral and cell-mediated immunity, which can influence intracellular HIV-1 replication [22,23].…”

“…Among HIV-positive individuals, zinc appears to have an important role in HIV-1 disease progression [24,25] as its deficiency has been associated with decreases in CD4 counts, progression to AIDS, and mortality [8,12,14,17,[26][27][28][29][30][31]. Zinc supplementation has shown to delay HIV-1 disease progression and decrease the rate of opportunistic infections in HIV-positive individuals with or without ART treatment [19,[32][33][34][35].…”

Review of randomized controlled trials of nutritional supplementation in people living with HIV

“…The children who received the zinc dose were less likely to get diarrhea and did not experience an increase in their viral load. In comparison, Cárcamo et al 76 supplemented 159 adults with HIV with a high dose of zinc (100 mg of elemental zinc) during episodes of diarrhea and did not find an effect on the duration or remission of diarrhea. The comparison of these two studies suggest that zinc supplementation, at lower doses and as prevention, is more effective than during episodes of diarrhea at a very high dose.…”

“…76 Reports from RCTs that supplemented multivitamins with minerals demonstrated better outcomes than supplementation with a single nutrient. 77 Supplementation with multiple nutrients compared to a single nutrient on HIV disease outcomes suggests a synergistic interaction among nutrients (Tables 1 and 2), especially with nutritional antioxidants with a high level of metabolic interactions.…”