TO DETERMINE THE ZINC LEVEL AND ITS CORRELATION WITH CD4 COUNT BEFORE AND AFTER ZINC SUPPLEMENTATION IN HIV INFECTED PATIENTS

Abstract

Introduction: Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Zinc is a known to maintain a healthy immune system. Low levels of zinc in plasma predict a threefold increase in mortality related to HIV, while adequate levels of the zinc in the blood have been associated with a slow disease progression, decrease in viral load and HIV RNA, increase in CD4 count, a decrease in the risk for diarrhea, bacterial and opportunistic infections.Zinc deficiency which is common among the HIV infected persons, is overlooked So, we conducted this study to analyze the level of serum zinc level in HIV infected patients and to find out correlation between serum zinc level and CD4 count before and after 6 months of zinc supplementation. Methods: This study enrolled 54 HIV infected patients above 18 years of age who visited the Medicine outpatient department or the ART Centeror admitted to the medicine ward, Regional institute of Medical Sciences (RIMS), Imphalfor a period of 2 years(October 2019 to October 2021). Serum zinc level, CD4 count, HIV viral load before and after 6 months of zinc supplementation and other routine blood investigations were done. Zinc deficiency was defined by serum Zinc level (< 70mcg/dl).Zinc supplementation (12 mg/day for female, 15 mg/day for male) had been done for the duration of 6 months in the form of oral zinc sulfate. Result: A total of 54 HIV infected patients under ART were enrolled in our study. As per WHO clinical staging, majority of the patients (79.6%) belonged to stage1, the mean duration + SD of HIV was 10.9815 + 8.1229 years. Most of them (46.3%) have CD4 count in the range of 200-500 cells/mm3 while maximum patients (70.4%) had viral load <50 (Target not detected). Majority of the patients (50%) had serum zinc level in the 60-70 mcg/dl while 18.5% of them had zinc level < 50 mcg/dl. There was statistically significant improvement in level of serum zinc and CD4 count, but no improvement in viral load after 6 months of supplementation of zinc.The association with CD4 count was not statistically significant. Conclusion: The present study showed that the majority of patients (92.6%) had zinc deficiency at baseline. There was increase in the mean serum zinc level, CD4 count after 6months of zinc supplementation but no improvement in viral load. Zinc deficiency was reduced to only (31.5%) patients. Hence, this study conclude that zinc deficiency is common among HIV patients and zinc supplementation as an adjunct therapy can significantly improve zinc deficiency and CD4 count in HIV infected patients on ART without any adverse side-effects of zinc supplementation thereby decreasing the risk for bacterial and opportunistic infections.