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The activation of the immune system is associated with profound alteration of zinc metabolism. In human immunodeficiency type 1 (HIV-l) infection serum zinc is frequently decreased. To investigate a potential role of immune system activation on urinary zinc wasting, we compared urinary zinc and l1eopterin levels in 52 patients with HIV-J infection. In addition, serum zinc was studied in 25 of the patients. We confinned earlier reports of decreased serum zinc levels in the patients. As expected, urinary neopterin was significantly increased in HIV-l infection, the highest values being reached in AIDS patients. Urinary zinc concentrations were not statistically different between patients and controls. However, a positive correlation existed between urinary zinc and neopterin levels and between neopterin and zinc clearance coefficient in patients with more advanced stages of HIV infection. No correlation between serum zinc and urinary neopterin or urinary zinc was found. The data indicate that, in addition to malabsorption, chronic immune activation may contribute to the development of zinc deficiency by urinary zinc wasting.

Are Disturbances of Zinc Metabolism in Human Immunodeficiency Virus Type I (HIV-I) Infection Caused By Immune Activation?