title: Trial of zinc supplements in relation to pregnancy outcomes, hematologic indicators, and T cell counts among HIV-1-infected women in Tanzania.
abstract: BACKGROUND
  In observational studies, the zinc status of HIV-infected persons has been associated with both positive and adverse clinical outcomes. Such endpoints may affect the risk of adverse birth outcomes among HIV-infected women.
  
  
  OBJECTIVE
  We examined the effects of zinc supplements on birth outcomes, hematologic indicators, and counts of T lymphocyte subsets among 400 HIV-infected pregnant women.
  
  
  METHODS
  Eligible women between 12 and 27 wk of gestation were randomly assigned to daily oral supplementation with either 25 mg Zn or placebo between recruitment and 6 wk after delivery. All women received iron, folic acid, and multivitamin supplements irrespective of the experimental assignment.
  
  
  RESULTS
  We observed no significant differences in birth weight, duration of gestation, or fetal and neonatal mortality between women in the zinc and placebo groups. Hemoglobin concentrations increased between baseline and 6 wk postpartum in both groups. However, the rise in hemoglobin over this period was significantly lower (P = 0.03) in the zinc group (x +/- SD: 11.5 +/- 17.9 g/L) than in the placebo group (15.2 +/- 18.6 g/L). Similarly, the changes in red blood cell count and in packed cell volume over the same period were significantly lower in the zinc group (P < 0.01 and P = 0.01, respectively). Zinc had no effect on CD4(+), CD8(+), or CD3(+) cell counts during the follow-up period.
  
  
  CONCLUSIONS
  Because of the lack of beneficial effects of zinc on adverse pregnancy outcomes and the likelihood of negative effects on hemoglobin concentrations, no compelling evidence exists to support the addition of zinc to prenatal supplements intended for pregnant HIV-infected women.
authors.affiliation: Department of Nutrition, Muhimbili University, College of Health Sciences, Dar es Salaam, Tanzania. mina@hsph.harvard.edu
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villamor
authors.forename: Gernard I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: Gretchen
authors.initials: G
authors.lastname: Antelman
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.forename: Willy
authors.initials: W
authors.lastname: Urassa
authors.forename: David
authors.initials: D
authors.lastname: Hunter
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000187:drug effects*; D016516:CD4-CD8 Ratio; D005260:Female; D015658:HIV Infections / Q000097:blood*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D016176:T-Lymphocyte Subsets / Q000187:drug effects*; D013636:Tanzania; D015032:Zinc / Q000494:pharmacology*
chemical_list: D015032:Zinc