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