Pre-Antiretroviral Therapy Serum Selenium Concentrations Predict WHO Stages 3, 4 or Death but not Virologic Failure Post-Antiretroviral Therapy

Nutrients

Rupak Shivakoti⁶  Nikhil Gupte⁶  Wei-Teng Yang⁶  Noluthando Mwelase⁴  Cecilia Kanyama⁹  Alice M. Tang⁵  Sandy Pillay¹⁴  Wadzanai Samaneka¹¹  Cynthia Riviere⁷  Sima Berendes¹²  Javier R. Lama¹  Sandra W. Cardoso^6,8  Patcharaphan Sugandhavesa^2,6  Richard D. Semba^6,10  Parul Christian^3,6  Thomas B. Campbell^6,13  Amita Gupta⁶ 

[1]Asociacion Civil Impacta Salud y Educacion, Lima, 4, Peru

[2] E-Mail:

[3]Research Institute for Health Sciences, Chiang Mai 50200, Thailand

[4] E-Mail:

[5]Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

[6] E-Mail:

[7]Department of Medicine, University of Witwatersrand, Johannesburg 2050, South Africa

[8] E-Mail:

[9]Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA

[10] E-Mail:

[11]Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

[12] E-Mails:

[13]Les Centres GHESKIO, Port-Au-Prince, HT-6110, Haiti

[14] E-Mail:

[15]STD/AIDS Clinical Research Laboratory, Instituto de Pesquisa Clinica Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil

[16] E-Mail:

[17]University of North Carolina Lilongwe, Lilongwe, Private Bag A-104, Malawi

[18] E-Mail:

[19]Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

[20] E-Mail:

[21]University of Zimbabwe Clinical Research Centre, Harare 999, Zimbabwe

[22] E-Mail:

[23]International Public Health Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK

[24] E-Mail:

[25]Department of Medicine, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USA

[26] E-Mail:

[27]Durban International Clinical Research Site, Durban University of Technology, Durban 4001, South Africa

[28] E-Mail:

关键词: HIV;    selenium;    antiretroviral therapy;    nutrition;    treatment failure;    cohort studies;   

DOI  :  10.3390/nu6115061

来源: mdpi

【 摘 要 】

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.

【 授权许可】

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© 2014 by the authors; licensee MDPI, Basel, Switzerland.