Relationship between plasma selenium concentrations and lower genital tract levels of HIV-1 RNA and interleukin type 1|[beta]|

doi:doi:10.1038/sj.ejcn.1602567

European Journal of Clinical Nutrition (2007) 61, 542–547. doi:10.1038/sj.ejcn.1602567; published online 6 December 2006

Relationship between plasma selenium concentrations and lower genital tract levels of HIV-1 RNA and interleukin type 1

Guarantor: R Kupka.

Contributors: GIM, DH and WWF contributed to the study design. CX and DA performed the laboratory analyses for CVL samples. RK carried out the data analyses, interpreted the results and wrote the initial draft of the manuscript. All authors participated in data interpretation and contributed to the final version of the manuscript. WWF and GIM are principal investigators of the study.

R Kupka¹, G I Msamanga², C Xu³, D Anderson³, D Hunter^1,4 and W W Fawzi^1,4

¹Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
²Department of Community Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
³Fearing Laboratory, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
⁴Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

Correspondence: Dr R Kupka, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA, USA. E-mail: rkupka@post.harvard.edu

Received 25 March 2006; Revised 28 September 2006; Accepted 2 October 2006; Published online 6 December 2006.

Top

Abstract

Objective:

To examine the relationship between selenium nutritional status and intermediates of human immunodeficiency virus (HIV)-1 transmission.

Design:

Prospective cohort study.

Setting:

A study clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Subjects:

A total of 340 HIV-1-infected pregnant women with gestational ages 12–27 weeks.

Methods:

Women's plasma selenium concentrations were determined at enrollment and modeled as tertiles (tertile 1: <114 g/l (reference); tertile 2: 114–131 g/l; tertile 3: >131 g/l). Cervicovaginal lavage specimens were obtained at 36 weeks of gestation to determine HIV-1 RNA and interleukin-1 (IL-1) levels. In subgroup analyses, 123 women with genital tract infections at enrollment were excluded.

Results:

Plasma selenium concentrations greater than or equal to 114 g/l were related to increased risk of lower-genital shedding of HIV-1 RNA. Excluding women with genital tract infections strengthened the associations (relative risk (RR) tertile 2: 1.46, 95% confidence interval (CI)=1.10, 1.92; RR tertile 3: 1.39, 95% CI=1.05, 1.84). There was evidence for an association between plasma selenium concentrations greater than or equal to 114 g/l and increased HIV-1 RNA levels among the entire cohort and after excluding women with genital tract infections. There was no association between plasma selenium and IL-1 concentrations.

Conclusions:

High selenium status may lead to increased risk of genital HIV-1 shedding, but data from other studies indicate that the evidence is mixed. Results from ongoing selenium trials are awaited to clarify the impact of selenium on HIV-1-related transmission endpoints.

Sponsorship:

National Institute of Child Health and Human Development (NICHD R01 32257) and the Fogarty International Center (NIH D43 TW00004).

Keywords:

selenium, HIV infection, virus shedding, vagina, maternal to child transmission

Top

Original Article