title: Relationship between plasma selenium concentrations and lower genital tract levels of HIV-1 RNA and interleukin type 1beta.
abstract: OBJECTIVE
  To examine the relationship between selenium nutritional status and intermediates of human immunodeficiency virus (HIV)-1 transmission.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A study clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.
  
  
  METHODS
  A total of 340 HIV-1-infected pregnant women with gestational ages 12-27 weeks.
  
  
  METHODS
  Women's plasma selenium concentrations were determined at enrollment and modeled as tertiles (tertile 1: <114 microg/l (reference); tertile 2: 114-131 microg/l; tertile 3: >131 microg/l). Cervicovaginal lavage specimens were obtained at 36 weeks of gestation to determine HIV-1 RNA and interleukin-1beta (IL-1beta) levels. In subgroup analyses, 123 women with genital tract infections at enrollment were excluded.
  
  
  RESULTS
  Plasma selenium concentrations >or=114 microg/l were related to increased risk of lower-genital shedding of HIV-1 RNA. Excluding women with genital tract infections strengthened the associations (relative risk (RR) tertile 2: 1.46, 95% confidence interval (CI)=1.10, 1.92; RR tertile 3: 1.39, 95% CI=1.05, 1.84). There was evidence for an association between plasma selenium concentrations >or=114 microg/l and increased HIV-1 RNA levels among the entire cohort and after excluding women with genital tract infections. There was no association between plasma selenium and IL-1beta concentrations.
  
  
  CONCLUSIONS
  High selenium status may lead to increased risk of genital HIV-1 shedding, but data from other studies indicate that the evidence is mixed. Results from ongoing selenium trials are awaited to clarify the impact of selenium on HIV-1-related transmission endpoints.
  
  
  BACKGROUND
  National Institute of Child Health and Human Development (NICHD R01 32257) and the Fogarty International Center (NIH D43 TW00004).
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. rkupka@post.harvard.edu
authors.forename: R
authors.initials: R
authors.lastname: Kupka
authors.forename: G I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: C
authors.initials: C
authors.lastname: Xu
authors.forename: D
authors.initials: D
authors.lastname: Anderson
authors.forename: D
authors.initials: D
authors.lastname: Hunter
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis*; D009752:Nutritional Status; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood*; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D012643:Selenium / Q000097:blood*; D013636:Tanzania; D014621:Vagina / Q000821:virology*; D017201:Virus Shedding
chemical_list: D053583:Interleukin-1beta; D012367:RNA, Viral; D012643:Selenium