Suppression of Human Immunodeficiency Virus Type 1 Viral Load With Selenium Supplementation

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 µg/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 (⌬) in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (⌬=32.2±24.5 vs 0.5±8.8 µg/L; PϽ.001), and greater levels predicted decreased HIV-1 viral load (PϽ.02), which predicted increased CD4 count (PϽ.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 µg/L displayed poor treatment adherence (56.8%±29.8%), HIV-1 viral load elevation (⌬=ϩ0.29±1.1 log 10 units), and decreased CD4 count (⌬=−25.8±147.4 cells/µL). In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 µg/L evidenced excellent treatment adherence (86.2%±13.0%), no change in HIV-1 viral load (⌬=−0.04±0.7 log 10 units), and an increase in CD4 count (⌬=ϩ27.9±150.2 cells/µL). 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.

Review of randomized controlled trials of nutritional supplementation in people living with HIV

“…In contrast, most of the studies after the initiation of ART used single nutrients such as zinc, selenium, calcium and vitamin D, which have been recognized to be deficient after initiation of ART. 39,67,[88][89][90]102,105,106 The report from Isanaka et al 87 suggests that supplementation with multivitamin at the RDA level is still safe in coadministration with ART, but high doses of vitamins should be avoided. Another study assessed the effect of vitamin supplements on HIV shedding in breast milk in HIV-infected lactating women.…”

“…39,67,88,90,102 However, the articles led by Isanaka et al, 87 Austin et al, 86 and Kaiser et al 23 reported the use of multiple combinations of multivitamins.…”

“…29,33,34,[53][54][55] Although a Cochrane review 56 found no definite evidence of the role of nutritional supplementation on morbidity, mortality, and HIV disease progression among PLWH, and vitamin A supplementation seems to be beneficial only in children, subsequent reports from RCTs of supplementation have found benefits for both adults and children. [23][24][25]39,[57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] ART and nutritional supplementation are not in contradiction, as concluded by another review, 73 as each of them support the recovery of the immune system by different mechanisms.…”

Oxidants and Antioxidants in the Pathogenesis of HIV/AIDS

“…Furthermore, studies support that antioxidant deficiency leads to a more rapid HIV-associated disease progression. Since oxidative agents and antioxidant deficiency have such a tremendous role in advancing disease, researchers believe that antioxidant supplementation may suppress HIV viral loads, thereby restoring immune function and potentially slowing the progression of AIDS [41].…”

Effect of Selenite on T-Cell Mitogenesis: Contribution of ROS Production and Apoptosis Signal-Regulating Kinase 1

“…Selenium deficiencies have been implicated in accelerated disease progression and poorer survival among populations infected with human immunodeficiency virus, 5) and improvements in immunocompetence have been reported when selenium-deficient and virus-infected hosts were administered dietary selenium. 6) In cellular immune reactions, selenium has been shown to promote cell growth, 7,8) protect against apoptosis, 9,10) be involved in the production of cytokines, 11) and induce transcription factor nuclear factor-κB (NF-κB). 12) However, selenium has also been shown to inhibit cell growth, 13,14) induce cell death 15) or apoptosis, 16,17) and suppress NF-κB.…”