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Low levels of selenium
are associated with numerous detrimental conditions (Table
2). (2, 4, 5) Research in Miami led to the belief that low levels
of selenium might influence HIV disease progression. (9, 10) HIV,
as well as other viruses, might reduce the ability to mount an effective
immune response by depleting the host's selenium supply. (5) Low
selenium is 15 times more significant than low CD4 count as a risk factor
for mortality. (10) Baum
and colleagues continue to investigate the role of selenium in HIV disease.
(12)
SELENIUM DEFICIENCY
Results from numerous
cross-sectional studies reported that AIDS patients exhibit clinical selenium
deficiency (defined as < 85 micrograms (µg) Se/L) or plasma selenium
concentrations lower than non-infected controls. Selenium deficiency reported
in HIV-infected patients in both early and end-stage disease (6, 13-17)
may be due to reduced intake and absorption and increased use and loss
of nutrients. (5)
In HIV infection, decreased
serum or erythrocyte selenium levels have been associated with (1)
increased progression to AIDS, (2) greater incidence of OI and (3)
decreased survival. Selenium deficiency appears to be related to poor prognosis
and to specific clinical characteristics of HIV disease. (9, 18-22)
Additionally, it has been demonstrated that selenium deficiency, independent
of CD4+ T-cell counts and antiretroviral treatment, is a significant predictor
of HIV-related mortality. (9) Of interest to those with HIV and
Hepatitis C co-infection, a study by Look and colleagues showed that the
decline in selenium levels was greater than that of individuals without
Hepatitis C. (21) In pediatric HIV-infection, a low plasma level
of selenium is an independent predictor of mortality and appears to be
associated with faster disease progression. (23-25) In a three-year,
observational study on the effects of highly active antiretroviral therapy
(HAART) on micronutrient profiles, the authors concluded that (1)
selenium and zinc deficiencies are dependent on immune status and sex and
(2) HAART reduced selenium and zinc deficiencies are independent
of CD4+ T-cell counts. (26)
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