Micronutrient status in relationship to mortality in HIV-1 disease.

Selenium deficiency has been demonstrated to be a significant predictor of HIV-related mortality, independent of CD4 over time, CD4 < 200 at baseline, and antiretroviral treatment. Although selenium deficiency in healthy humans is relatively rare (Cohen et al. 1989, Lockitch, 1989), a number of studies have documented a decline in plasma selenium levels and decreased glutathione peroxidase activity in individuals with HIV/AIDS (Dworkin et al. 1988, Cirelli et al. 1991, Mantero-Atienza et al. 1991, Staal et al. 1992, Allavena et al. 1995). These findings are of particular concern in light of selenium's influence on immune function, viral replication, and survival. As recent investigations (Delmas-Beauvieux et al. 1996) indicate that supplementation with selenium may help to increase the enzymatic defense systems in HIV-infected patients, further studies to determine possible mechanisms and clinical trials to evaluate the effect of selenium supplementation on HIV disease progression are essential.