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Immunologic Effect of Zinc Supplementation in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy: A Randomized, Double-Blind, Placebo-Controlled Trial

Lodha, Rakesh MD*; Shah, Nipam MPH*; Mohari, Nivedita MD*; Mukherjee, Aparna MD*; Vajpayee, Madhu MD; Singh, Ravinder MSc; Singla, Mohit MBBS*; Saini, Savita MSc*; Bhatnagar, Shinjini PhD*; Kabra, Sushil Kumar MD*

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 August 2014 - Volume 66 - Issue 4 - p 386–392
doi: 10.1097/QAI.0000000000000191
Clinical Science

Background: We conducted this study to assess the immunologic effect of daily 20 mg zinc supplementation for 24 weeks in HIV-infected children older than 6 months receiving highly active antiretroviral therapy (ART).

Methods: Fifty-two HIV-infected children older than 6 months in whom ART was initiated were randomized to receive either 20 mg of zinc or placebo for a period of 24 weeks. Children underwent clinical examination, anthropometry, and laboratory evaluations: CD4% and count, viral load, and serum zinc level at baseline, 12 weeks, and 24 weeks. The primary outcome evaluated was CD4% value at the end of 12 and 24 weeks of study intervention in the enrolled children.

Results: Of 52 children enrolled, 49 completed the study. The median CD4% value rose from 10% to 23% at 12 weeks and to 24.5% at 24 weeks in the zinc group, whereas in the placebo group, the value rose from 11% to 20% at 12 weeks and to 22% at 24 weeks (P = 0.188 for comparison between the zinc and the placebo group at 12 wk and P = 0.3 for comparison at 24 wk). The median (interquartile range) log reductions in the viral load at 12 weeks in the 2 arms were similar at 12 (P = 0.84) and 24 weeks (P = 0.43).

Conclusions: Supplementation of 20 mg zinc daily for 24 weeks did not have any statistically significant effect on the increase in CD4%, decrease in viral load, anthropometric indices, and morbidity profile in HIV-infected children started on ART.

Departments of *Pediatrics; and

Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Correspondence to: Rakesh Lodha, MD, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India (e-mail:

Supported by the Indian Council of Medical Research, Ansari Nagar, New Delhi; the funding agency had no role in the study design, conduct, or analysis of data.

The authors have no conflicts of interest to disclose

Received December 10, 2013

Accepted March 26, 2014

© 2014 by Lippincott Williams & Wilkins