Researchers at the University of Miami recruited 121 HIV positive male subjects in the late 1980s and early 1990s as part of a study on malnutrition and HIV infection. They recently analysed the data, looking at the impact of levels of zinc and copper on survival, and published their results, which we report on in this story.
None of the subjects were injection-drug users. On average, subjects were monitored for about three years. At the start of the study, the profile of subjects was as follows:
At the end of the study, researchers analysed their data and divided the subjects into two groups:
Note: The 16% (19 subjects) who did not survive died from complications due to HIV infection.
The researchers found that over the course of the study subjects who died were five times more likely than the survivors to have received AZT. Perhaps this was related to the fact that 42% of subjects who died had fewer than 200 CD4+ cells. Having low CD4+ counts would have been an indication for doctors to prescribe AZT. Only 4% of survivors had fewer than 200 CD4+ cells.
The researchers found that subjects who had less-than-normal levels of zinc were five times more likely to die than subjects who had normal levels of zinc. As well, those subjects who had more copper in their blood than zinc were eight times more likely to die than subjects with a more balanced level of copper.
In tracking the levels of zinc in the blood of subjects over the course of the study, the researchers concluded that zinc deficiency is more likely to occur in PHAs whose immune systems degrade faster than in other PHAs. Perhaps this accelerated zinc deficiency may be due to malabsorption caused by AIDS-related infections. Reduced zinc levels could in turn lead to further decline of the immune system.
The research team suggests that monitoring levels of zinc and copper in the blood might be a useful part of the health management of PHAs. Because many PHAs in North America use HAART, another study examining the changes in zinc and copper levels in HAART-users may be useful.
The body needs both zinc and copper but there is a balance between the two minerals that affects their absorption. Too much zinc causes less copper to be absorbed and too much copper causes less zinc to be absorbed. Nutrition researcher Dr. Lark Lands suggests a daily zinc intake of between 25 mg and 75 mg ("in addition to what is contained in a multivitamin/mineral supplement"). She also recommends a daily dose of between 2 mg and 4 mg copper to balance the dose of zinc. These two minerals should not be taken together at the same time.
REFERENCES
1. Lai H, Lai S, Shor-Posner G, et al. Plasma zinc, copper, copper:zinc ratio, and survival in a cohort of HIV-1-infected homosexual men. Journal of Acquired Immune Deficiency Syndromes 2001;27:56-62.
2. Myers CD. HIV and copper and zinc revisited (brochure). April 1994, page 11.
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Copyright © 2001 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca.
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