Psychological burden in the era of HAART: impact of selenium therapy.
OBJECTIVE
To determine the impact of nutritional (selenium) chemoprevention on levels of psychological burden (anxiety, depression, and mood state) in HIV/AIDS.


METHODS
A randomized, double-blind, placebo-controlled selenium therapy (200 microg/day) trial was conducted in HIV+ drug users from 1998-2000. Psychosocial measures (STAI-State and Trait anxiety, BDI-depression, and POMS- mood state), clinical status (CD4 cell count, viral load), and plasma selenium levels were determined at baseline and compared with measurements obtained at the 12-month evaluation in 63 participants (32 men, 31 women).


RESULTS
The majority of the study participants reported elevated levels of both State (68%) and Trait (70%) anxiety. Approximately 25% reported overall mood distress (POMS > 60) and moderate depression (BDI > 20). Psychological burden was not influenced by current drug use, antiretroviral treatment, or viral load. At the 12-month evaluation, participants who received selenium reported increased vigor (p = 0.004) and had less anxiety (State, p = 0.05 and Trait, p = 0.02), compared to the placebo-treated individuals. No apparent selenium-related affect on depression or distress was observed. The risk for state anxiety was almost four times higher, and nearly nine times greater for trait anxiety in the placebo-treated group, controlling for antiretroviral therapy, CD4 cell decline (> 50 cells) and years of education.


CONCLUSIONS
Selenium therapy may be a beneficial treatment to decrease anxiety in HIV+ drug users who exhibit a high prevalence of psychological burden.
Shor-Posner
Gail
G
University of Miami School of Medicine, USA. gshor@med.miami.edu
Lecusay
Robert
R
Miguez
Maria-Jose
MJ
Moreno-Black
Geraldine
G
Zhang
Guoyan
G
Rodriguez
Noaris
N
Burbano
Ximena
X
Baum
Marianna
M
Wilkie
Frances
F
D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control*; D018791:CD4 Lymphocyte Count; D017281:Cost of Illness; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D019587:Dietary Supplements; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D016015:Logistic Models; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000097:blood; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D012643:Selenium / Q000008:administration & dosage* / Q000097:blood; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000821:virology; D016896:Treatment Outcome
D000975:Antioxidants; D018977:Micronutrients; D012643:Selenium