Selenium Requirements in HIV

HIV/AIDS malabsorption can deplete levels of many nutrient leading to nutritional deficiencies. Deficiencies in antioxidants during HIV infection facilitate the development of oxidative stress and may thus contribute to immune dysregulation and HIV replication.[i]

The trace element selenium is a key nutrient in antioxidant defence. Its deficiency as evidenced by low plasma selenium concentrations is common in HIV-infected populations. [ii]Selenium deficiency is associated with decreased immune cell counts, increased disease progression and high risk of death in the HIV/AIDS population[iii][iv].

As a cofactor of glutathione peroxidase (GSH-Px), the anti-oxidative characteristic of selenium helps protect cells from oxidative stress, thus potentially slowing progression of the disease.[v] HIV infection induces chronic oxidative stress, which has been linked to apoptosis of T-lymphocytes during HIV disease and increased rates of HIV replication by activating the nuclear transcription factor-kB (NF-kB) cell gene.

A clinical trial investigating 125 HIV-positive men and women linked selenium deficiency with a higher rate of death from HIV[vi]. In this study, selenium plasma levels < 1.08 µmol/L were associated with a 10.8-fold increased risk of mortality (95% CI= 2.37 - 49.2).

In a small study of 24 children with HIV who were observed for 5 years, those with low selenium levels died at a younger age, which may indicate faster disease progression.[vii]

In a French study, serum selenium levels were inversely associated with mortality risk over a 12 month period in a cohort of 95 HIV-1 infected drug users and nonusers. [viii]

Results of the research studies have led to experts to suggest that selenium status may be a significant predictor of survival for those infected with HIV[ix]. According to NIH guidelines on General Nutrition, Weight Loss and Wasting Syndrome, Chap 5B, ‘the use of daily multivitamin supplements containing selenium (20-40 mg) is advisable especially in patients experiencing weight loss”.

[i] Allard, J.P., Aghdassi, E., Chau, J., Salit, I. & Walmsley, S. (1998) Oxidative stress and plasma antioxidant micronutrients in humans with HIV infection. Am.J.Clin. Nutr. 67:143-147

[ii] Olmstead, L.Shrauzer, G., Flres-Arce

[iii] Look MP, Rockstroh JK, Rao GS, Kreuzer KA, Spengler U, Sauerbruch T. Serum selenium versus lymphocyte subsets and markers of disease progression and inflammatory response in human immunodeficiency virus-1 infection. Biol Trace Elem Res 1997;56(1):31-41.

[iv] Singhal N and Austin J. A clinical review of micronutrients in HIV infection. J Int Assoc Physicians AIDS Care 2002;1:63-75.

[v] Romero-Alvira D and Roche E. The keys of oxidative stress in acquired immune deficiency syndrome apoptosis. Medical Hypotheses 1998;51(2):169-73.

[vi] Baum MK, Shor-Posner G, Lai S, Zhang G, Lai H, Fletcher MA, Sauberlich H, Page JB. High risk of HIV-related mortality is associated with selenium deficiency. J Acquir Immune Defic Syndr Hum Retrovirol 1997;15:370-4.

[vii] Campa A, Shor-Posner G, Indacoche F, Zhang G, Lai H, Asthana D, Scott GB, Baum MK. Mortality risk in selenium-deficient HIV-positive children. J Acquir Immune Defic Syndr Hum Retrovirol 1999;15:508-13.

[viii] Constans, J., Pellegrin, J.L., Sergeant, C., Simonoff, M., Pellegrin, I ,Fleury, H., Leng, B., & Contri, C. (1995) Serum selenium predicts outcome in HIV infection [letter]. J Acquir Immune Defic. Syndr. Hum. Retrovirol. 10:392.

[ix] Baum MK and Shor-Posner G. Micronutrient status in relationship to mortality in HIV-1 disease. Nutr Rev 1998;56:S135-9.