Oral zinc supplementation in the treatment of HIV-infected children.

Primary zinc (Zn) deficiency has been reported to cause immune dysfunction; secondary Zn deficiency has been noted in HIV-infected adults; and 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/mm3 were supplemented with oral elemental zinc at 1.8-2.2 mg/kg/day for 3 to 4 weeks. HIV p24 antigen (p24) levels, T-cell subsets, and serum Zn and copper (Cu) levels were measured before and at the end of Zn supplementation. Clinical assessment 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. After 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 p24 had decreased p24 levels. Clinical scores improved in only four patients. This study does not demonstrate impressive short-term benefit from oral Zn supplementation in HIV-infected children.