Zinc Deficiency Among Children Living with HIV on Antiretroviral therapy in Lagos, Nigeria

Zinc is an essential micronutrient vital for immune function and growth. HIV infection commonly leads to zinc deficiency due to increased demand, malabsorption, and reduced intake, potentially worsening disease progression. While antiretroviral therapy (ART) improves overall health, its specific impact on zinc levels in HIV-positive children, particularly in Nigeria where ART is now widespread, remains under-researched. This study aims to determine the prevalence of zinc deficiency in HIV-positive children on HAART in Lagos, Nigeria.

This study was a subgroup analysis of the HIV arm of a comparative study conducted over 11 months. A total of 170 HIV-positive children were assessed. Although the eligibility criteria spanned 6 months to 18 years, the actual age range of the recruited cohort was 9 months to 18 years, as no eligible children aged 6-8 months were enrolled during the study period. Serum zinc levels were measured using a conventional atomic absorption spectrophotometer, with normal values defined as 70 to 125 µg/dL.

Participants aged 9 months to 18 years (mean 10.9±3.4 years) had been on ART for an average of 7.8 years, with 60.0% on first-line medication. Zinc deficiency prevalence was 69.4% (118/170). While no associations were found with sociodemographic, anthropometric, or clinical variables (all p>0.05), longer ART duration was significantly associated with normal zinc levels (9.1±3.4 vs 7.3±3.6 years, p=0.002; OR=0.860, 95% CI: 0.770-0.960, p=0.007).

The study found high zinc deficiency prevalence among HIV-positive children in Lagos, Nigeria, despite ART participation. Longer HAART duration may protect against zinc deficiency. Routine zinc assessment is needed, and randomized controlled trials should explore zinc supplementation benefits for improving HIV outcomes in this vulnerable population.