Plasma selenium concentrations are sufficient and associated with protease inhibitor use in treated HIV-infected adults

Authors: HILEMAN, CORRILYNN - Metrohealth Medical Center; DIRAJLAL-FARGO, SAHERA - Case Western Reserve University (CWRU); LAM, SUET - Case Western Reserve University (CWRU); KUMAR, JESSICA - Rainbow Babies And Children’s Hospital; Combs, Gerald; Lacher, Craig; MCCOMSEY, GRACE - Rainbow Babies And Children’s Hospital

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/22/2015
Publication Date: 8/12/2015
Publication URL: http://handle.nal.usda.gov/10113/61453
Citation: Hileman, C.O., Dirajlal-Fargo, S., Lam, S., Kumar, J., Combs, G.F., Lacher, C.P., Mccomsey, G.A. 2015. Plasma selenium concentrations are sufficient and associated with protease inhibitor use in treated HIV-infected adults. Journal of Nutrition. Available: doi: 10.3945/jn.115.214577.

Interpretive Summary: Background: Selenium (Se) is an essential constituent of selenoproteins which play significant roles in antioxidant defense and inflammatory cascades. Selenium deficiency is associated with disease states characterized by inflammation including cardiovascular disease (CVD). While HIV infection has been associated with low Se, the role of Se status in HIV-related CVD is unclear. Objective: We sought to assess associations between Se and markers of inflammation, immune activation and subclinical vascular disease in HIV-infected adults on contemporary antiretroviral therapy (ART) and to determine if statin therapy modifies Se status. Design: As part of a randomized clinical trial of rosuvastatin in HIV-infected adults on stable ART, plasma Se levels were determined at entry, week 24 and week 48. Spearman correlation and linear regression analyses were used to assess relationships. Changes in Se over 24 and 48 weeks were compared between-groups. Results: 147 HIV-infected adults were included. All participants were on ART. Median current CD4+ count was 613 and 76% had HIV-1 RNA =48 copies/ml (range <20-600). Median plasma Se level was 122 ng/mL (range 62-200). At baseline, higher Se was associated with current protease inhibitor (PI) use, lower BMI and higher proportion of activated CD8+ T cells (CD8+CD38+HLA-DR+), but not markers of inflammation or subclinical vascular disease. Over 48 weeks Se levels increased in the statin group (p<0.01 within-group); however, the change did not reach significance between groups (+13.1 vs +5.3 ng/mL; p=0.14 between-groups). Conclusions: Plasma Se levels were within the normal range for the background population and were not associated with subclinical vascular disease in HIV-infected adults on contemporary ART. The association of current PI use with higher Se may have implications for ART allocation especially in resource-limited countries. Also, it appears that statin therapy may increase Se levels; however, larger studies are necessary to confirm this finding.

Technical Abstract: Background: Selenium (Se) is an essential constituent of selenoproteins which play significant roles in antioxidant defense and inflammatory cascades. Selenium deficiency is associated with disease states characterized by inflammation including cardiovascular disease (CVD). While HIV infection has been associated with low Se, the role of Se status in HIV-related CVD is unclear. Objective: We sought to assess associations between Se and markers of inflammation, immune activation and subclinical vascular disease in HIV-infected adults on contemporary antiretroviral therapy (ART) and to determine if statin therapy modifies Se status. Design: As part of a randomized clinical trial of rosuvastatin in HIV-infected adults on stable ART, plasma Se levels were determined at entry, week 24 and week 48. Spearman correlation and linear regression analyses were used to assess relationships. Changes in Se over 24 and 48 weeks were compared between-groups. Results: 147 HIV-infected adults were included. All participants were on ART. Median current CD4+ count was 613 and 76% had HIV-1 RNA =48 copies/ml (range <20-600). Median plasma Se level was 122 ng/mL (range 62-200). At baseline, higher Se was associated with current protease inhibitor (PI) use, lower BMI and higher proportion of activated CD8+ T cells (CD8+CD38+HLA-DR+), but not markers of inflammation or subclinical vascular disease. Over 48 weeks Se levels increased in the statin group (p<0.01 within-group); however, the change did not reach significance between groups (+13.1 vs +5.3 ng/mL; p=0.14 between-groups). Conclusions: Plasma Se levels were within the normal range for the background population and were not associated with subclinical vascular disease in HIV-infected adults on contemporary ART. The association of current PI use with higher Se may have implications for ART allocation especially in resource-limited countries. Also, it appears that statin therapy may increase Se levels; however, larger studies are necessary to confirm this finding.