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Free Content A randomised controlled trial of oral zinc on the immune response to tuberculosis in HIV-infected patients

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SETTING: The National HIV Unit, Singapore.

OBJECTIVE: To test whether zinc supplementation improves the immune response to tuberculosis in HIV-positive patients.

DESIGN: A double-blind, randomised, placebo-controlled trial of 28 days of oral zinc sulphate (50 mg of elemental zinc) or placebo in stable adult HIV-positive patients receiving antiretroviral therapy with a CD4 count <200 cells/μl.

METHODS: IFN-γ response to mycobacterial antigen stimulation, CD4/8 cell count, lymphocyte subsets, T-cell receptor excision circle (TREC) levels and viral load were measured at baseline and day 28.

RESULTS: Thirty-two patients received zinc and 34 placebo. There was no significant change in the IFN-γ response to human PPD stimulation in the zinc or placebo groups (placebo baseline: 0.42 ± 1.03, day 28: 0.84 ± 1.21 IU/ml, zinc baseline: 1.26 ± 2.41, day 28: 1.39 ± 1.88 IU/ml, P = 0.31 between groups), nor any of the other mycobacterial antigens tested. There were no changes in absolute CD4/8 cell levels or other lymphocyte subsets, TREC or viral load. Baseline zinc levels were normal in 62/66 (93.9%) patients.

CONCLUSIONS: We found no evidence for recommending pharmacological supplementation with oral zinc in HIV-positive patients without zinc deficiency.
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Keywords: HIV; immunophenotyping; interferon Type II; tuberculosis; zinc

Document Type: Regular Paper

Affiliations: 1: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 2: Department of Medicine, Monash University, Melbourne, Australia 3: Infectious Diseases Research Centre, Tan Tock Seng Hospital, Singapore 4: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; and Infectious Diseases Research Centre, Tan Tock Seng Hospital, Singapore

Publication date: December 1, 2005

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

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