Selenium status is associated with accelerated HIV disease progression among HIV-1-infected pregnant women in Tanzania.
Selenium deficiency has been implicated in accelerated disease progression and poorer survival among populations infected with HIV in developed countries, yet these associations remain unexamined in developing countries. Among 949 HIV-1-infected Tanzanian women who were pregnant, we prospectively examined the association between plasma selenium levels and survival and CD4 counts over time. Over the 5.7-y median follow-up time, 306 of 949 women died. In a Cox multivariate model, lower plasma selenium levels were significantly associated with an increased risk of mortality (P-value, test for trend = 0.01). Each 0.1 micromol/L increase in plasma selenium levels was related to a 5% (95% CI = 0%-9%) decreased risk of mortality. Plasma selenium levels were not associated with time to progression to CD4 cell count < 200 cells/mm(3) but were weakly and positively related to CD4 cell count in the first years of follow up. Selenium status may be important for clinical outcomes related to HIV disease in sub-Saharan Africa.
Department of Nutrition, Harvard School of Public Health, Boston MA, USA. rkupka@post.harvard.edu
Roland
R
Kupka
Gernard I
GI
Msamanga
Donna
D
Spiegelman
Steve
S
Morris
Ferdinand
F
Mugusi
David J
DJ
Hunter
Wafaie W
WW
Fawzi
D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D008288:Malaria / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D009026:Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000821:virology*; D011446:Prospective Studies; D012643:Selenium / Q000097:blood* / Q000172:deficiency; D013636:Tanzania / Q000453:epidemiology; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D014810:Vitamin E / Q000097:blood
D014801:Vitamin A; D014810:Vitamin E; D012643:Selenium