Research: HURWITZ and co-workers,

Listed in Issue 147

Abstract

HURWITZ and co-workers, Behavioral Medicine Research Center, University of Miami, c/o VA Medical Center, FL 33125, USA,  bhurwitz@miami.edu, have investigated selenium as a suppressor of the human immunodeficiency virus.

Background

Despite findings that selenium supplementation may improve immune functioning, definitive evidence of its impact on human immunodeficiency virus (HIV) disease severity is lacking. The aim of this study was to provide such evidence.

Methodology

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 lymphocyte count after 9 months of treatment.

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 mean change in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (p < 0.001), and greater levels predicted decreased HIV-1 viral load (p < 0.02), which predicted increased CD4 count (p < 0.04). 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, HIV-1 viral load elevation, and decreased CD4 count. In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 microg/L evidenced excellent treatment adherence, no change in HIV-1 viral load, and an increase in CD4 count.

Conclusion

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 disease.

References

Hurwitz BE et al. Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Archives of Internal Medicine 167 (2): 148-154, Jan 22, 2007.

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