High risk of HIV-related mortality is associated with selenium deficiency.
To determine the independent contribution of specific immunologic and nutritional factors on survival in HIV-1 disease, CD4 cell count, antiretroviral treatment, plasma levels of vitamins A, E, B6, and B12 and minerals selenium and zinc were considered in relation to relative risk for HIV-related mortality. Immune parameters and nutrients known to affect immune function were evaluated at 6-month intervals in 125 HIV-1-seropositive drug-using men and women in Miami, FL, over 3.5 years. A total of 21 of the HIV-1-infected participants died of HIV-related causes during the 3.5-year longitudinal study. Subclinical malnutrition (i.e., overly low levels of prealbumin, relative risk [RR] = 4.01, p < 0.007), deficiency of vitamin A (RR = 3.23, p < 0.03), vitamin B12 deficiency (RR = 8.33, p < 0.009), zinc deficiency (RR = 2.29.1, p < 0.04), and selenium deficiency (RR = 19.9, p < 0.0001) over time, but not zidovudine treatment, were shown to each be associated with HIV-1-related mortality independent of CD4 cell counts <200/mm3 at baseline, and CD4 counts over time. When all factors that could affect survival, including CD4 counts <200/mm3 at baseline, CD4 levels over time, and nutrient deficiencies were considered jointly, only CD4 counts over time (RR = 0.69, p < 0.04) and selenium deficiency (RR = 10.8, p < 0.002) were significantly associated with mortality. These results indicate that selenium deficiency is an independent predictor of survival for those with HIV-1 infection.
Baum
M K
MK
Department of Psychiatry and Behavioral Sciences, University of Miami, School of Medicine, Florida 33136, U.S.A.
Shor-Posner
G
G
Lai
S
S
Zhang
G
G
Lai
H
H
Fletcher
M A
MA
Sauberlich
H
H
Page
J B
JB
D000328:Adult; D001361:Avitaminosis / Q000150:complications; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000401:mortality*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009748:Nutrition Disorders / Q000150:complications; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012643:Selenium / Q000172:deficiency*; D019966:Substance-Related Disorders / Q000150:complications; D015032:Zinc / Q000172:deficiency
D011228:Prealbumin; D012643:Selenium; D015032:Zinc