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

TitlePre-antiretroviral therapy serum selenium concentrations predict WHO stages 3, 4 or death but not virologic failure post-antiretroviral therapy.
Publication TypeJournal Article
Year of Publication2014
AuthorsShivakoti R, Gupte N, Yang W-T, Mwelase N, Kanyama C, Tang AM, Pillay S, Samaneka W, Riviere C, Berendes S, Lama JR, Cardoso SW, Sugandhavesa P, Semba RD, Christian P, Campbell TB, Gupta A
Corporate AuthorsNWCS 319 and PEARLS study team
JournalNutrients
Volume6
Issue11
Pagination5061-78
Date Published2014 Nov
ISSN2072-6643
KeywordsAdult, Anti-HIV Agents, Atazanavir Sulfate, Benzoxazines, Body Mass Index, C-Reactive Protein, CD4 Lymphocyte Count, 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
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.

DOI10.3390/nu6115061
Alternate JournalNutrients
PubMed ID25401501
PubMed Central IDPMC4245580
Grant ListAI069450 / AI / NIAID NIH HHS / United States
AI68636 / AI / NIAID NIH HHS / United States
P30 AI042853 / AI / NIAID NIH HHS / United States
R01 AI080417 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States