Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: A randomized controlled trial

Barry E. Hurwitz, Johanna R. Klaus, Maria M. Llabre, Alex Gonzalez, Peter J. Lawrence, Kevin J. Maher, Jeffrey M. Greeson, Marianna K. Baum, Gail Shor-Posner, Jay S. Skyler, Neil Schneiderman

Research output: Contribution to journalArticle

144 Scopus citations

Abstract

Background: Despite findings that selenium supplementation may improve immune functioning, definitive evidence of its impact on human immunodeficiency virus (HIV) disease severity is lacking. Methods: High selenium yeast supplementation (200 μg/d) was evaluated in a double-blind, randomized, placebo-controlled trial. Intention-to-treat analyses assessed the effect on HIV-1 viral load and CD4 count after 9 months of treatment. Unless otherwise indicated, values are presented as mean±SD. Results: Of the 450 HIV-1-seropositive men and women who underwent screening, 262 initiated treatment and 174 completed the 9-month follow-up assessment. Mean adherence to study treatment was good (73.0%±24.7%) with no related adverse events. The intention-to-treat analyses indicated that the mean change (Δ) in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (Δ = 32.2±24.5 vs 0.5±8.8 μg/L; P<.001), and greater levels predicted decreased HIV-1 viral load (P<.02), which predicted increased CD4 count (P<.04). Findings remained significant after covarying age, sex, ethnicity, income, education, current and past cocaine and other drug use, HIV symptom classification, antiretroviral medication regimen and adherence, time since HIV diagnosis, and hepatitis C virus coinfection. Follow-up analyses evaluating treatment effectiveness indicated that the non-responding selenium-treated subjects whose serum selenium change was less than or equal to 26.1 μg/L displayed poor treatment adherence (56.8%±29.8%), HIV-1 viral load elevation (Δ = +0.29±1.1 log10 units), and decreased CD4 count (Δ = -25.8±147.4 cells/μL). In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 μg/L evidenced excellent treatment adherence (86.2%±13.0%), no change in HIV-1 viral load (Δ = -0.04±0.7 log10 units), and an increase in CD4 count (Δ = +27.9±150.2 cells/μL). Conclusions: Daily selenium supplementation can suppress the progression of HIV-1 viral burden and provide indirect improvement of CD4 count. The results support the use of selenium as a simple, inexpensive, and safe adjunct therapy in HIV spectrum disease. Trial Registration: isrctn.org Identifier: IS-RCTN22553118

Original languageEnglish (US)
Pages (from-to)148-154
Number of pages7
JournalArchives of internal medicine
Volume167
Issue number2
DOIs
StatePublished - Jan 22 2007

ASJC Scopus subject areas

  • Internal Medicine

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