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2007-9-3 23:13:55 |
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Taking selenium supplements is an effective yet inexpensive preventive measure every HIV positive patient may take to get the disease under control, results of a U.S. government-sponsored trial suggest. But results also show some patients may not absorb selenium well enough to have a beneficial effect. Dr. Barry E. Hurwitz and associates at the University of Miami in Florida found that taking selenium supplements actually suppresses replication of the HIV virus in some HIV-positive patients and increases the number of beneficial CD4 immune cells. Keeping the HIV virus suppressed is a goal most HIV therapies mean to achieve, but this can be quite a task because antiretroviral therapy often can¡¯t get the HIV under control. Early studies have linked low levels of selenium in the blood to high HIV virulence, more opportunistic infections, and high risk of death from HIV. The trial was sponsored by the National Institute of Health and is published in the January 22, 2007 issue of the Archives of Internal Medicine. In the trial, about 260 HIV-infected adults were randomly assigned 200-milligram capsules of inactive yeast (placebo) daily or 200-milligram capsules of high-selenium yeast for nine months. 174 patients including 83 on the placebo completed the trial. The selenium enriched yeast was selected from Selenomax, Nutrition 21 Inc. because of its high concentrations of organic, bioavailable form of selenium. In the placebo group, virus counts increased by 10,000 to 20,000 copies/milliliter after nine months whereas viral loads remained unchanged and CD4 cell counts increased in the group receiving the selenium supplements. In 50 patients the researchers identified as "selenium responders," the serum selenium levels were significantly higher than the average and their virus counts actually decreased on average by 10,000 copies/milliliter. The researchers noted that there was evidence indicating that the selenium responders tended to better adhere to the selenium supplementation than nonresponders. But some patients who complied well did not seem to be able to absorb selenium. The viral counts of nonresponders were comparable to that of those who did not receive the selenium supplement. The selenium enriched yeast costs about $15 for a 2-month treatment. But not all the supplements may deliver the same benefits as selenium in some supplements may not be absorbed well. The results of the trial indicate that selenium levels in the blood are important for HIV positive people and selenium supplementation can help those who can not get enough selenium through their diet. The researchers concluded that selenium supplements may be a simple, inexpensive, and safe adjunct therapy to antiretroviral medications for HIV. Previous studies have found that selenium sufficiency improves immune response and protect against viral infections. In the case of HIV, studies have already suggested selenium plays an important role in reducing oxidative stress in HIV-infected cells and possibly suppressing HIV replication. Before the current trial, a few small trials were conducted to determine the effect of selenium supplementation on the HIV patients. In two trials, reported by Constans J, Conri C, and Sergeant C. in the September, 1999 issue of Nutrition, selenium supplements led to some subjective improvement, but no improvement in biological parameters related to AIDS progression. In one trial, 400 mcg/day of selenium-enriched yeast was used and in the other, 80 mcg/day of sodium selenite plus 25 mg/day of vitamin C was trialed. In yet another trial of 15 HIV positive patients who were supplemented with 100 mcg/day of sodium selenite for one year, researchers found the supplementation reduced oxidative stress, a biological marker of immunologic activation and HIV progression. But unlike the current study, the trial found there were no differences in CD4 T cell count, an important biological marker of progression of HIV infection, or mortality between the supplemented and unsupplemented patients. This trial was reported by Constans J, Delmas-Beauvieux MC, and Sergeant C, et al. in the March 1996 issue of Clin Infect Dis. The recommended daily allowance for selenium set in 2000 by the Food and Nutrition Board (FNB) of the Institute of Medicine is 15 mcg/day for infants aged 0-6 months, 20 mcg/day for infants aged 7-12 months and children aged 1-3 years, 30 mcg/day for children aged 4-8 years, 40 mcg/day for children aged 9-14 years, 55 mcg/day for those aged 14 or above. The RDA for selenium is 60 mcg/day for pregnant women and 70 mcg/day for breastfeeding mothers. The richest dietary source is Brazil nuts from selenium-rich soil, one ounce of which contains 839 mcg, which doubles the tolerable upper intake level of 400 mcg/day. Other selenium-rich foods include salmon, halibut, brown rice, chicken light meat, pork and whole wheat bread. |
