High Risk of HIV-Related Mortality Is Associated With Selenium Deficiency

Abstract

To determine the independent contribution of specific immunologic and nutritional factors on survival in HIV-1 disease, CD4 cell count, antiretroviral treatment, plasma levels of vitamins A, E, B6, and B12 and minerals selenium and zinc were considered in relation to relative risk for HIV-related mortality. Immune parameters and nutrients known to affect immune function were evaluated at 6-month intervals in 125 HIV-1-seropositive drug-using men and women in Miami, FL, over 3.5 years. A total of 21 of the HIV-1-infected participants died of HIV-related causes during the 3.5-year longitudinal study. Subclinical malnutrition (i.e., overly low levels of prealbumin, relative risk [RR] = 4.01, p < 0.007), deficiency of vitamin A (RR = 3.23, p < 0.03), vitamin B12 deficiency (RR = 8.33, p < 0.009), zinc deficiency (RR = 2.29.1, p < 0.04), and selenium deficiency (RR = 19.9, p < 0.0001) over time, but not zidovudine treatment, were shown to each be associated with HIV-1-related mortality independent of CD4 cell counts <200/mm3 at baseline, and CD4 counts over time. When all factors that could affect survival, including CD4 counts <200/mm3 at baseline, CD4 levels over time, and nutrient deficiencies were considered jointly, only CD4 counts over time (RR = 0.69, p < 0.04) and selenium deficiency (RR = 10.8, p < 0.002) were significantly associated with mortality. These results indicate that selenium deficiency is an independent predictor of survival for those with HIV-1 infection.

The importance of selenium to human health

“…Work carried out by Baum and co-workers at the University of Miami showed that selenium-deficient HIV patients are 19.9 times more likely (95% CI 5.52-71.9; p<0.0001) to die from HIV-related causes than those with adequate levels. 18 Selenium deficiency is defined by Baum as a plasma level at or below 85 mcg/L, a level not attained in many northern European countries (see below), e.g. a mean level of 60 mcg/L was found in a recent Scottish study.…”

“…15,18 Elucidation of the importance of novel viral selenoproteins may improve our understanding of HIV. 14 Baum With regard to cancer, an extended repeat of the NPC trial is now planned with cohorts in three European countries and the US, to see if the reduction of cancer risk and mortality with selenium supplementation previously observed can be replicated in other population groups.…”

Symposium on ‘Geographical and geological influences on nutrition’ Factors controlling the distribution of selenium in the environment and their impact on health and nutrition

“…Yu et al (63) , Bjelakovic et al (64) In US patients with relatively low Se status (plasma Se < 85 mg/l) HIV infection progresses more rapidly to AIDS with higher mortality Baum et al (65) , Campa et al (66) In a Tanzanian observational study of 949 HIV-positive pregnant women mortality decreases with increase in plasma Se ( > 85 mg/l) over 5-year follow-up period Kupka et al (67) Cancer Inverse relationship between crop and human Se status and cancer incidence in North America…”

Zinc supplementation to HIV-1-infected pregnant women: Effects on maternal anthropometry, viral load, and early mother-to-child transmission

“…In some studies, low-serum zinc was related to progression to AIDS (Graham et al, 1991), decreases in CD4 cell counts (Baum et al, 2003) and mortality (Baum et al, 1997a(Baum et al, , 2003, and low-dietary intake was associated with decreased survival (Baum et al, 2003). Conversely, another prospective study reported an inverse association between zinc consumption and survival of HIV-positive adults (Tang et al, 1996).…”