SERUM ZINC STATUS OF HUMAN IMMUNODEFICIENCY VIRUS INFECTED CHILDREN AGED 6 MONTHS TO 15 YEARS ON HIGHLY ACTIVE ANTI-RETROVIRAL THERAPY AT THE JOS UNIVERSITY TEACHING HOSPITAL, JOS, NIGERIA

Abstract

Zinc is an essential micronutrient that is critical in human nutrition due to its roles in gene expression,
cell replication and development. Its deficiency is common in children living in low income countries,
more so in malnourished and HIV infected children. Despite increased access to highly active
antiretroviral therapy which has been found to improve micronutrient status, deficiencies still abound
especially in areas where daily food intake is not micronutrient rich.
This was a cross sectional study carried out at the Paediatric Infectious Diseases Clinic of AIDS
Prevention Initiative in Nigeria (APIN) Centre Jos and Paediatric Outpatient Clinic of the Jos
University Teaching Hospital, Jos Nigeria that determined the serum zinc status of Human
Immunodeficiency virus infected children aged 6 months to 15 years on highly active antiretroviral
therapy (HAART) compared with age and sex matched HIV negative controls. Also the relationship
between serum zinc concentration and anthropometric indices and immunological status of the HIV
infected children were determined.

Two hundred and seventy HIV infected children and two hundred and seventy age and sex matched
HIV negative controls were recruited for this study.
Serum zinc levels were determined using atomic absorption spectrophotometry.
The prevalence of serum zinc deficiency was 38.8% and 24.6% among HIV infected children and
HIV negative controls respectively (p<0.0001). Ninety eight percent of the HIV infected children
were on HAART at the time of study.
The mean serum zinc concentration of HIV- infected children was 14.61±7.65µmol/L and was
significantly lower than 18.74±9.58µmol/L in HIV negative controls (p<0.0001). No statistically
significant differences were found in nutritional status classified by BMI z-score for age and sex,
HAZ (stunting) and WAZ (underweight) between the proportions of serum zinc deficient and non
serum zinc deficient HIV infected children. When nutritional status of HIV infected children were
compared with that of their matched HIV negative controls, significantly more HIV infected children
were stunted (28.4% v 15.4%, p = 0.0001) and were underweight (7.0% v 2.8%, p = 0.042).
There is a positive correlation between serum zinc concentrations and some immunological
parameters such as CD4+ count and CD4 percentage of the HIV infected children. The relationship is
statistically significant in children less than 5 years for CD4+ count (Correlation coefficient r = 0.318,
p = 0.012) but not significant for CD4% in the same age group (Correlation coefficient r =0.053, p =
0.683). For HIV infected children 5-15 years, there is a positive correlation between CD4+ counts and
serum zinc concentrations, although the relationship is not statistically significant (Correlation
coefficient r = 0.067, p = 0.281).
Considering the high prevalence of zinc deficiency among HIV infected children who are on HAART
found in this study and the positive correlation between immunological status and serum zinc
concentrations, it is being suggested that zinc supplementation to HAART in HIV infected children
may improve their immune status.

More evidence from supplementation studies are needed however to evaluate the beneficial roles of
adding zinc to HAART in the management of HIV infected children in this environment.