Possible Impact of Select Trace Mineral Deficiency in HIV Seropositive Pregnant Women with/without Malaria Co-infection in NAUTH, Nnewi, Nigeria

Abstract

Aims: To evaluate the impact of HIV and malaria on serum Zinc (zn), Selenium (se) and Magnesium (mg) in HIV seropositive pregnant women in Nnewi, Nigeria. Study Design:  This is a case-control study. Place and Duration of Study: Prevention of Mother to Child transmission (PMTCT) of HIV  Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi, (NAUTH), Nigeria, between December, 2017 and April, 2018. Methodology: We included 122 consented female participants; 32 HIV seropositive pregnant women with malaria parasitaemia, 30 HIV seropositive pregnant women without malaria parasitaemia, 30 Malaria infected pregnant women, 30 pregnant women without HIV or malaria parasitaemia, aged between 18 and 42 years. Screening for HIV antibodies and malaria parasite was double screened using National algorithm, rapid detection technique (RDT) and Giemsa staining microscopy technique respectively. Micronutrient levels were determined using atomic absorption spectrophotometry (AAS). Results: When the mean zn, sel and mg levels were compared between the test and control groups, significant decreases in serum zn (37.34 ± 6.7, 36.70 ± 4.39), sel (29.93 ± 6.02, 28.00 ± 5.04) and mg (2.41 ± 0.46, 2.33 ± 0.14) were observed in HIV seropositive pregnant participants with/without malaria co-infection when compared with their corresponding controls Zn (45.1 ± 7.83, 50.36 ± 8.73); Sel (31.46 ± 6.19, 31.96 ± 6.81); Mg (2.62 ± 0.30) and (P < .05 respectively). Body mass index (BMI) was significantly decreased while diastolic blood pressure (DBP) and systolic blood pressure (SBP) were significantly increased in HIV seropositive pregnant women with malaria compared with their seronegative counterparts (P < .05 respectively). Conclusion: The significant loss in BMI with derangement in serum zn, sel and mg levels in HIV seropositive pregnant women with/without malaria co-infection indicates high degree of malnutrition while the increased blood pressure suggests high blood pressure which might predispose the pregnant mothers to pre-eclampsia if not properly managed. Adequate micronutrient supplementation and effective anti malaria agent is strictly advocated in the routine management of HIV infected mothers during pregnancy to reduce the severity of the co-infection and adverse pregnancy complications especially in areas of malaria endemic transmissions.