Pre-antiretroviral therapy serum selenium concentrations predict WHO stages 3, 4 or death but not virologic failure post-antiretroviral therapy.

Cynthia Riviere, Amita Gupta, Thomas B Campbell, Parul Christian, Richard D Semba, Patcharaphan Sugandhavesa, Sandra W Cardoso, Javier R Lama, Sima Berendes, Rupak Shivakoti, Wadzanai Samaneka, Sandy Pillay, Alice M Tang, Cecilia Kanyama, Noluthando Mwelase, Wei-Teng Yang, Nikhil Gupte

Journal: Nutrients 2015;6(11):5061-78

PMID: 25401501

Free Full Text on MDPI View on PubMed

Abstract

A case-cohort study, within a multi-country trial of antiretroviral therapy (ART) efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings (PEARLS)), was conducted to determine if pre-ART serum selenium deficiency is independently associated with human immunodeficiency virus (HIV) disease progression after ART initiation. Cases were HIV-1 infected adults with either clinical failure (incident World Health Organization (WHO) stage 3, 4 or death by 96 weeks) or virologic failure by 24 months. Risk factors for serum selenium deficiency (<85 μg/L) pre-ART and its association with outcomes were examined. Median serum selenium concentration was 82.04 μg/L (Interquartile range (IQR): 57.28-99.89) and serum selenium deficiency was 53%, varying widely by country from 0% to 100%. In multivariable models, risk factors for serum selenium deficiency were country, previous tuberculosis, anemia, and elevated C-reactive protein. Serum selenium deficiency was not associated with either clinical failure or virologic failure in multivariable models. However, relative to people in the third quartile (74.86-95.10 μg/L) of serum selenium, we observed increased hazards (adjusted hazards ratio (HR): 3.50; 95% confidence intervals (CI): 1.30-9.42) of clinical failure but not virologic failure for people in the highest quartile. If future studies confirm this relationship of high serum selenium with increased clinical failure, a cautious approach to selenium supplementation might be needed, especially in HIV-infected populations with sufficient or unknown levels of selenium.

Address: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, University of Witwatersrand, Johannesburg 2050, South Africa. [email protected].; University of North Carolina Lilongwe, Lilongwe, Private Bag A-104, Malawi. [email protected].; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA. [email protected].; Durban International Clinical Research Site, Durban University of Technology, Durban 4001, South Africa. [email protected].; University of Zimbabwe Clinical Research Centre, Harare 999, Zimbabwe. [email protected].; Les Centres GHESKIO, Port-Au-Prince, HT-6110, Haiti. [email protected].; International Public Health Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK. [email protected].; Asociacion Civil Impacta Salud y Educacion, Lima, 4, Peru. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. [email protected].

DOI: 10.3390/nu6115061

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/hivmedicines.html

Other Literature Sources:

https://scite.ai/reports/25401501

Research Materials:

https://antibodies.cancer.gov/detail/CPTC-CRP-1

MeSH Terms: Adult, Alkynes, Anti-HIV Agents, Atazanavir Sulfate, Benzoxazines, Body Mass Index, C-Reactive Protein, CD4 Lymphocyte Count, Cyclopropanes, Deoxycytidine, Didanosine, Disease Progression, Emtricitabine, Female, HIV Infections, Humans, Lamivudine, Logistic Models, Male, Multivariate Analysis, Oligopeptides, Prospective Studies, Pyridines, Risk Factors, Selenium, World Health Organization, Zidovudine