The Efficacy of Zinc Supplementation to Prevent Progression to Immunologic Failure among HIV- Infected Adults A Meta-Analysis

Abstract

Adequate zinc is critical for immune function. HIV infection progressively destroys the immune system and increase the susceptibility to opportunistic infection. Some scientific papers have linked zinc deficiency with decrease CD4 lymphocyte. We conducted a meta-analysis to evaluate the efficacy of zinc supplementation for prevention of immunologic failure among HIV adults.

The review was conducted and reported according to the Preferred Reporting Items for systematic Reviews and Meta-analysis (PRISMA). Eligible studies regardless of their publication status were identified by searching electronic literature using PUBMED and Cochrane. We included all RCT comparing orally administered zinc with placebo. Assessment for study inclusion, data extraction and risk of bias analyses were performed in duplicate.

We included 7 trials involving 1,611 participants. Result showed a significant p value of 0.003. Out of 873 adult patients included in the study that was on zinc supplementation (experimental group), a total of 424 (48.57%) patients had progression of immunologic failure. On the other hand, out of 758 adult patients, a total of 418 (55.14%) patients that had immunologic failure on the controlled group. This showed a significant result with a p value of 0.003 and a C.I of 0.74 (0.61-0.90).

The results of our meta-analysis showed that oral zinc supplementation may prevent progression of immunologic failure among HIV infected adults. However, large high quality trials are needed before definitive recommendations for clinical practice can be made. Adverse effects were common and should be the point of future study, because a good safety and tolerance profile is essential to any supplement.