Use of protease inhibitors is associated with higher selenium levels in treated HIV infection
Selenium (Se) acts as a cofactor for several enzymes (selenoproteins) which have anti-inflammatory properties. In some studies, HIV-infected subjects have been found to be micronutrient deficient and it is known that Se can influence immune activation, inflammation and cardiovascular dysfunction.
We performed a cross-sectional study of HIV-infected adults on antiretroviral therapy (ART) with HIV-1 RNA ≤ 1000 copies/ml to assess relationships between selenium (Se) levels and demographics, HIV-related factors, markers of inflammation and immune activation, markers of oxidative stress, as well as cardiovascular disease (CVD) risk measures. Spearman correlation analysis and linear regression were utilized.
147 subjects were included; 78% men, 68% African American, 8% with Hepatitis C, 63% current smokers. Median age was 46.2 years, BMI 26.7 kg/m2 and eGFRcr 100 mL/min per 1.73 m2. Median known duration of HIV and cumulative duration of ART were 139 and 64 months. Median current and nadir CD4+ counts were 613 and 179 cells/mm3. 50% were on a protease inhibitor (PI) and 76% had HIV-1 RNA ≤ 48 copies/ml. Median Se level was 122 ng/ml. Demographics associated with higher Se included Caucasian race (p<0.01), male sex (p<0.01), lower BMI (p=0.02) and lower eGFRcr (p=0.04). Only current PI use (p<0.05) was associated with higher Se. Markers of inflammation, monocyte or lymphocyte activationand F2-isoprostanes were not associated with Se levels. In multivariable analysis, only Caucasian race (p<0.01), being on a PI (p=0.03) and lower BMI (p=0.01) were independently associated with higher Se. Of the CVD risk measures studied, paradoxically, flow mediated dilation of the brachial artery was inversely correlated with Se (ρ=-0.22; p=0.007); (ρ=-0.17; p=0.07 for men; ρ=0.09; p=0.62 for women). This association did not remain significant after adjustment for usual CVD risk factors. Coronary artery calcification and carotid intima media thickness were not associated with Se levels.
In this ART-experienced group, only being on a PI was associated with higher Se levels with regard to HIV-related factors. Markers of inflammation, immune activation, and oxidative stress were not associated with Se in this group. Further study is warranted to better understand the effect of Se on endothelial dysfunction in HIV.
N. J. Storer, None
D. E. Labbato, None
G. Combs, None
G. A. Mccomsey, None
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