Selenium supplementation in HIV-infected patients: is there any potential clinical benefit?

In HIV-infected patients undergoing antiretroviral therapy, the question of whether selenium supplementation has any therapeutic benefit is still open. With recent popular coverage of this issue, many patients have considered using selenium. Clinicians have a duty to ensure that the recommendations they make to their patients are evidence based. The literature search reported here showed that evidence to support standard selenium supplementation in patients with HIV is both limited and insufficient. To definitively answer this clinical question, the overall effect of selenium supplementation would need to be evaluated in a large randomized, controlled trial with solid methodology and strong internal validity. Although the available evidence for selenium supplementation is weak, its low toxicity and side effect profile seem to pose minimal risks, especially at low doses. For patients who want to add selenium to their regimen, discussing the potential risks and benefits as well as close follow-up is warranted.