Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/27738
Title: Pre-antiretroviral therapy serum selenium concentrations predict WHO stages 3, 4 or death but not virologic failure post-antiretroviral therapy
Authors: Shivakoti, Rupak
Gupte, Nikhil
Yang, Wei-Teng
Mwelase, Noluthando
Kanyama, Cecilia
Tang, Alice M.
Pillay, Sandy
Samaneka, Wadzanai
Riviere, Cynthia
Berendes, Sima
Lama, Javier R.
Cardoso, Sandra W.
Sugandhavesa, Patcharaphan
Semba, Richard D.
Christian, Parul
Campbell, Thomas B.
Gupta, Amita
Affilliation: Johns Hopkins University School of Medicine. Department of Medicine. Baltimore, MD, USA.
Johns Hopkins University School of Medicine. Department of Medicine. Baltimore, MD, USA.
Johns Hopkins University School of Medicine. Department of Medicine. Baltimore, MD, USA.
University of Witwatersrand. Department of Medicine. Johannesburg, South Africa.
University of North Carolina Lilongwe. Lilongwe, Malawi.
Tufts University School of Medicine. Department of Public Health and Community Medicine. Boston, MA, USA.
Durban University of Technology. Durban International Clinical Research Site. Durban, South Africa.
University of Zimbabwe Clinical Research Centre. Harare, Zimbabwe.
Les Centres GHESKIO. Port-Au-Prince, Haiti.
Liverpool School of Tropical Medicine. International Public Health Department. Liverpool, UK.
Asociacion Civil Impacta Salud y Educacion. Lima, Peru.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Research Institute for Health Sciences. Chiang Mai, Thailand.
Johns Hopkins University School of Medicine. Department of Ophthalmology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of International Health. Baltimore, MD, USA.
University of Colorado School of Medicine. Department of Medicine, Division of Infectious Diseases. Aurora.
Johns Hopkins University School of Medicine. Department of Medicine. Baltimore, MD, USA.
Abstract: A case-cohort study, within a multi-country trial of antiretroviral therapy (ART) efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings (PEARLS)), was conducted to determine if pre-ART serum selenium deficiency is independently associated with human immunodeficiency virus (HIV) disease progression after ART initiation. Cases were HIV-1 infected adults with either clinical failure (incident World Health Organization (WHO) stage 3, 4 or death by 96 weeks) or virologic failure by 24 months. Risk factors for serum selenium deficiency (<85 μg/L) pre-ART and its association with outcomes were examined. Median serum selenium concentration was 82.04 μg/L (Interquartile range (IQR): 57.28-99.89) and serum selenium deficiency was 53%, varying widely by country from 0% to 100%. In multivariable models, risk factors for serum selenium deficiency were country, previous tuberculosis, anemia, and elevated C-reactive protein. Serum selenium deficiency was not associated with either clinical failure or virologic failure in multivariable models. However, relative to people in the third quartile (74.86-95.10 μg/L) of serum selenium, we observed increased hazards (adjusted hazards ratio (HR): 3.50; 95% confidence intervals (CI): 1.30-9.42) of clinical failure but not virologic failure for people in the highest quartile. If future studies confirm this relationship of high serum selenium with increased clinical failure, a cautious approach to selenium supplementation might be needed, especially in HIV-infected populations with sufficient or unknown levels of selenium.
Keywords: HIV
Selenium
Antiretroviral therapy
Nutrition
Treatment failure
Cohort studies
Issue Date: 2014
Citation: SHIVAKOTI, Rupak et al. Pre-Antiretroviral Therapy Serum Selenium Concentrations Predict WHO Stages 3, 4 or Death but not Virologic Failure Post-Antiretroviral Therapy. Nutrients, v. 6, p. 5061-5078, 2014.
DOI: 10.3390/nu6115061
ISSN: 2072-6643
Copyright: open access
Appears in Collections:INI - Artigos de Periódicos

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