Abstract

The role of selenium as adjunct to haart among HIV infected individuals who are advanced in their disease

N.N. Odunukwe¹, D. Onwujekwe¹, O.O. Ezechi¹, P. Ezobi¹, T. Gbajabiamila¹, R. Anyanwu¹, E. Iloka¹, R. Adu¹, O. Nwogbe¹, R. Audu¹, E. Herbertson¹, E.O. Idigbe¹, P. Kanki²

¹Nigerian Institute of Medical Research, Clinical Science Division, Yaba, Nigeria, ²Harvard School of Public Health, Boston, United States

Background: In developing countries, HIV-1 infection impact on people is devastating. Poor nutrition and HIV-related adverse health outcomes contribute to a vicious cycle that should be slowed down by nutritional supplements. Past studies document decreased levels of antioxidants and selenium in people living with HIV/AIDS. Low serum micronutrient levels in HIV-positive individuals have been associated with immune impairment, disease progression, and increased mortality. This study examined the role of selenium supplement among HIV-positive individuals who were advanced in their disease and are receiving HAART.

Methods: A follow-up study of all HIV positive individuals with advanced disease recruited for HAART programme between February 2002 and June 2005. One hundred and seventy were on HAART plus Selenium supplement and 170 were on HAART only. Their viral load, CD4 cell count, Haematological and Biochemical indices were analysed at base line and 12 weekly intervals. At each visit adherence and nutritional counselling were given. Data generated were analysed using SPSS statistical software

Results: Of the 340 subjects recruited, 66% had CD4 cell counts < 50cells/µl. A comparison between those on HAART plus Selenium and those on HAART only showed that the rate of CD4 cell recovery was higher among the HAART plus Selenium group. The median CD4count increments from baseline to 64 weeks were +120cells/µl and +50cells/µl (P=0.02). Less hospital visits for treatment of OIs were recorded for individuals on HAART plus Selenium compare to those on HAART only. Weight gain was significantly higher in Selenium group (P £0.004). Median Haemoglobin increments from baseline to 64 weeks were +30g/l and +10g/l (Plus Selenium and non Selenium groups respectively).The median time for undetectable viral load was similar for the two groups (P £0.2).

Conclusions: Selenium supplementation resulted in higher CD4. This supports Selenium supplement as an adjunct to HAART in HIV positive individuals with severe immune suppression.

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