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Pre‐antiretroviral therapy (ART) selenium status predicts HIV clinical but not virologic failure post‐ART (LB326)
Author(s) -
Shivakoti Rupak,
Gupte Nikhil,
Yang WeiTeng,
Mwelase Noluthando,
Kanyama Cecilia,
Sugandhavesa Patcharaphan,
Semba Richard,
Christian Parul,
Campbell Thomas,
Gupta Amita
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.lb326
Subject(s) - selenium , medicine , selenium deficiency , viral load , antiretroviral therapy , human immunodeficiency virus (hiv) , cohort , cohort study , odds ratio , immunology , gastroenterology , oxidative stress , glutathione peroxidase , materials science , catalase , metallurgy
Selenium status, with important roles in oxidative stress and immunity, has a non‐linear U‐shaped association with all‐cause mortality in US populations; in HIV‐infected persons, low selenium is associated with increased viral load. Factors associated with selenium deficiency and whether selenium is independently associated with HIV ART outcomes in HIV‐infected persons is unknown. We performed a multi‐country case‐cohort where cases were HIV‐1 infected adults with either clinical failure (incident WHO stage 3, 4 or death by 96 weeks) or virologic failure (HIV RNA levels 蠅 1000 copies/mL for 2 successive visits at 蠅16 weeks). Median baseline selenium levels were 82.04 µg/L (IQR: 57.28 ‐ 99.89) and selenium deficiency prevalence was 53% varying widely by country from 0% (US) to 100% (Zimbabwe). Independent risk factors for baseline selenium deficiency (<85 µg/mL) were country, previous TB (adjusted odds ratio (aOR) 7.57, 95% CI 1.46‐39.21), low albumin (aOR 3.61, CI 1.13‐11.52), and log C‐reactive protein (aOR 2.74, CI 1.25‐6.02). Adjusted models showed a non‐linear U‐shaped association between selenium and clinical failure but no associations of selenium with HIV virologic failure. In summary, lower and higher levels of selenium pre‐ART were associated with increased hazards of clinical failure post‐ART. Selenium supplementation of HIV‐infected subjects initiating ART should be approached with caution.