Effect of Vitamin D, Selenium, or Zinc Supplementation in HIV: A Systematic Review.

Abstract

We conducted a systematic review to examine evidence from randomized controlled trials studying the effect of Vitamin D, selenium, or zinc supplementation in human immunodeficiency virus (HIV). An electronic literature search was carried out using Ovid Medline, Embase, CINHAL, Cochrane Center Register of Controlled Trials, Database of Systematic Reviews, Psych Info and PubMed. Eligible articles were assessed for methodological quality on the basis of the adequacy of the randomization process, concealment of allocation, blinding of intervention and outcome, and completeness of follow-up. A total of 24 single supplement trials (Vitamin D, selenium, and zinc) involving 5948 participants were included for this review. Evidence from seven Vitamin D trials showed no damaging or beneficial effect of Vitamin D supplementation on HIV disease progression in HIV-infected adults or children/adolescents. Six of the selenium studies found that providing daily selenium supplementation to HIV-infected adults' increased CD4 cell counts and reduce the risk of diarrhea morbidity and hospital admission rate for HIV-related conditions and opportunistic infection in HIV-infected adults. Evidence from eleven zinc trials showed some evidence of a potential beneficial effect of zinc supplementation on diarrhea morbidity and immune function. However, further research in larger and more diverse populations of HIV patients is required to fully investigate the effect of these nutrients on clinically relevant outcomes in HIV disease, the optimal dose, and the cost-benefit or cost-effectiveness of Vitamin D, selenium, or zinc supplementation.