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Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial.

Abstract

BACKGROUND

Despite findings that selenium supplementation may improve immune functioning, definitive evidence of its impact on human immunodeficiency virus (HIV) disease severity is lacking.

METHODS

High selenium yeast supplementation (200 mug/d) was evaluated in a double-blind, randomized, placebo-controlled trial. Intention-to-treat analyses assessed the effect on HIV-1 viral load and CD4 count after 9 months of treatment. Unless otherwise indicated, values are presented as mean +/- SD.

RESULTS

Of the 450 HIV-1-seropositive men and women who underwent screening, 262 initiated treatment and 174 completed the 9-month follow-up assessment. Mean adherence to study treatment was good (73.0% +/- 24.7%) with no related adverse events. The intention-to-treat analyses indicated that the mean change (Delta) in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (Delta = 32.2 +/- 24.5 vs 0.5 +/- 8.8 microg/L; P<.001), and greater levels predicted decreased HIV-1 viral load (P<.02), which predicted increased CD4 count (P<.04). Findings remained significant after covarying age, sex, ethnicity, income, education, current and past cocaine and other drug use, HIV symptom classification, antiretroviral medication regimen and adherence, time since HIV diagnosis, and hepatitis C virus coinfection. Follow-up analyses evaluating treatment effectiveness indicated that the nonresponding selenium-treated subjects whose serum selenium change was less than or equal to 26.1 microg/L displayed poor treatment adherence (56.8% +/- 29.8%), HIV-1 viral load elevation (Delta = +0.29 +/- 1.1 log(10) units), and decreased CD4 count (Delta = -25.8 +/- 147.4 cells/microL). In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 microg/L evidenced excellent treatment adherence (86.2% +/- 13.0%), no change in HIV-1 viral load (Delta = -0.04 +/- 0.7 log(10) units), and an increase in CD4 count (Delta = +27.9 +/- 150.2 cells/microL).

CONCLUSIONS

Daily selenium supplementation can suppress the progression of HIV-1 viral burden and provide indirect improvement of CD4 count. The results support the use of selenium as a simple, inexpensive, and safe adjunct therapy in HIV spectrum disease. Trial Registration isrctn.org Identifier: ISRCTN22553118.

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  • Authors+Show Affiliations

    ,

    Behavioral Medicine Research Center, University of Miami, c/o VA Medical Center, FL 33125, USA. bhurwitz@miami.edu

    , , , , , , , , ,

    Source

    Archives of internal medicine 167:2 2007 Jan 22 pg 148-54

    MeSH

    Adult
    CD4 Lymphocyte Count
    CD4-Positive T-Lymphocytes
    Dietary Supplements
    Double-Blind Method
    Female
    HIV Seropositivity
    HIV-1
    Humans
    Male
    Multivariate Analysis
    Selenium
    Viral Load

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17242315

    Citation

    Hurwitz, Barry E., et al. "Suppression of Human Immunodeficiency Virus Type 1 Viral Load With Selenium Supplementation: a Randomized Controlled Trial." Archives of Internal Medicine, vol. 167, no. 2, 2007, pp. 148-54.
    Hurwitz BE, Klaus JR, Llabre MM, et al. Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Arch Intern Med. 2007;167(2):148-54.
    Hurwitz, B. E., Klaus, J. R., Llabre, M. M., Gonzalez, A., Lawrence, P. J., Maher, K. J., ... Schneiderman, N. (2007). Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Archives of Internal Medicine, 167(2), pp. 148-54.
    Hurwitz BE, et al. Suppression of Human Immunodeficiency Virus Type 1 Viral Load With Selenium Supplementation: a Randomized Controlled Trial. Arch Intern Med. 2007 Jan 22;167(2):148-54. PubMed PMID: 17242315.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. AU - Hurwitz,Barry E, AU - Klaus,Johanna R, AU - Llabre,Maria M, AU - Gonzalez,Alex, AU - Lawrence,Peter J, AU - Maher,Kevin J, AU - Greeson,Jeffrey M, AU - Baum,Marianna K, AU - Shor-Posner,Gail, AU - Skyler,Jay S, AU - Schneiderman,Neil, PY - 2007/1/24/pubmed PY - 2007/2/17/medline PY - 2007/1/24/entrez SP - 148 EP - 54 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 167 IS - 2 N2 - BACKGROUND: Despite findings that selenium supplementation may improve immune functioning, definitive evidence of its impact on human immunodeficiency virus (HIV) disease severity is lacking. METHODS: High selenium yeast supplementation (200 mug/d) was evaluated in a double-blind, randomized, placebo-controlled trial. Intention-to-treat analyses assessed the effect on HIV-1 viral load and CD4 count after 9 months of treatment. Unless otherwise indicated, values are presented as mean +/- SD. RESULTS: Of the 450 HIV-1-seropositive men and women who underwent screening, 262 initiated treatment and 174 completed the 9-month follow-up assessment. Mean adherence to study treatment was good (73.0% +/- 24.7%) with no related adverse events. The intention-to-treat analyses indicated that the mean change (Delta) in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (Delta = 32.2 +/- 24.5 vs 0.5 +/- 8.8 microg/L; P<.001), and greater levels predicted decreased HIV-1 viral load (P<.02), which predicted increased CD4 count (P<.04). Findings remained significant after covarying age, sex, ethnicity, income, education, current and past cocaine and other drug use, HIV symptom classification, antiretroviral medication regimen and adherence, time since HIV diagnosis, and hepatitis C virus coinfection. Follow-up analyses evaluating treatment effectiveness indicated that the nonresponding selenium-treated subjects whose serum selenium change was less than or equal to 26.1 microg/L displayed poor treatment adherence (56.8% +/- 29.8%), HIV-1 viral load elevation (Delta = +0.29 +/- 1.1 log(10) units), and decreased CD4 count (Delta = -25.8 +/- 147.4 cells/microL). In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 microg/L evidenced excellent treatment adherence (86.2% +/- 13.0%), no change in HIV-1 viral load (Delta = -0.04 +/- 0.7 log(10) units), and an increase in CD4 count (Delta = +27.9 +/- 150.2 cells/microL). CONCLUSIONS: Daily selenium supplementation can suppress the progression of HIV-1 viral burden and provide indirect improvement of CD4 count. The results support the use of selenium as a simple, inexpensive, and safe adjunct therapy in HIV spectrum disease. Trial Registration isrctn.org Identifier: ISRCTN22553118. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/17242315/full_citation L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.167.2.148 DB - PRIME DP - Unbound Medicine ER -