Randomized controlled trial of zinc supplementation for persistent diarrhea in adults with HIV-1 infection.
BACKGROUND
In children, zinc supplementation reduces the incidence and severity of diarrhea.


METHODS
HIV-infected adults with > or =7 days of diarrhea recruited at 3 tertiary hospitals in Lima, Peru, received a zinc sulfate capsule containing 50 mg of elemental zinc twice daily or an identical placebo for 14 days. Outcomes included persistence of diarrhea at day 14 and time until cessation of diarrhea.


RESULTS
The 81 subjects randomized to zinc and 78 randomized to placebo were comparable at baseline, except for higher prevalences of certain enteric pathogens in the zinc group; complete follow-up rates were 62% and 69%, respectively. Zinc concentrations were consistent with zinc deficiency at follow-up in 94% of placebo recipients and 66% of zinc recipients (P = 0.01). Persistence of diarrhea at day 14 according to follow-up interview (60% for zinc-treated patients and 57.4% for placebo-treated patients) or to patient diary (42.2% vs. 31.9%) did not differ significantly. Adjusting for enteric pathogens and CD4 count, the hazard ratio (HR) for zinc supplementation and cessation of diarrhea (according to the diaries) was 0.91 (95% confidence interval [CI]: 0.50 to 1.64).


CONCLUSIONS
Supplemental zinc had no significant effect on the duration or remission of diarrhea in HIV-infected adults.
Cárcamo
César
C
Department of Epidemiology, University of Washington, Seattle, WA 98104, USA.
Hooton
Thomas
T
Weiss
Noel S
NS
Gilman
Robert
R
Wener
Mark H
MH
Chavez
Victor
V
Meneses
Rosario
R
Echevarria
Juan
J
Vidal
Margot
M
Holmes
King K
KK
D000328:Adult; D003967:Diarrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D019587:Dietary Supplements; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010919:Placebos; D015032:Zinc / Q000008:administration & dosage / Q000172:deficiency / Q000627:therapeutic use*
D010919:Placebos; D015032:Zinc