Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation - A randomized controlled trial
Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation - A randomized controlled trial
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DOI：
10.1001/archinte.167.2.148
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发表时间：
2007-01-22
影响因子：
--
通讯作者：
Schneiderman, Neil
中科院分区：
文献类型：
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作者：
Hurwitz, Barry E.;Klaus, Johanna R.;Schneiderman, Neil
背景资料：尽管研究结果表明，硒补充剂可以改善免疫功能，其对人类免疫缺陷病毒（HIV）疾病的严重程度的影响的确切证据是lacking.Methods：高硒酵母补充剂（200微克/天）进行了评估，在一个双盲，随机，安慰剂对照试验。意向治疗分析评估了治疗9个月后对HIV-1病毒载量和CD 4计数的影响。除非另有说明，值均表示为平均值+/- SD.Results：450 HIV-1血清阳性的男性和女性谁进行了筛选，262开始治疗和174完成了9个月的后续评估。对研究治疗的平均依从性良好（73.0% +/- 24.7%），无相关不良事件。意向性治疗分析表明，硒治疗组血清硒浓度的平均变化（Delta）显著增加，而安慰剂治疗组则没有（Delta = 32.2 +/- 24.5 vs 0.5 +/- 8.8 μ g/L; P <0.001），更高的水平预示着HIV-1病毒载量的降低（P <0.01）。02），预测CD 4计数升高（P < . 05）。04）。在改变年龄、性别、种族、收入、教育、当前和过去可卡因和其他药物使用、艾滋病毒症状分类、抗逆转录病毒药物治疗方案和依从性、自艾滋病毒诊断以来的时间和丙型肝炎病毒合并感染后，结果仍然显著。评估治疗效果的随访分析表明，血清硒变化小于或等于26.1 μ g/L的无应答硒治疗受试者显示治疗依从性差（56.8% +/- 29.8%）、HIV-1病毒载量升高（Delta = + 0.29 +/- 1.1 log（10）单位）和CD 4计数降低（Delta = -25.8 +/- 147.4个细胞/μ L）。相比之下，血清硒增加大于26.1 μ g/L的硒治疗受试者证明了极好的治疗依从性（86.2% +/- 13.0%），HIV-1病毒载量无变化（Delta = -0.04 +/- 0.7 log 10单位），以及CD 4计数增加（Delta = + 27.9 +/- 150.2 cells/mu L）。结论：每日补充硒可抑制HIV-1病毒负荷的进展，并间接改善CD 4计数。结果支持使用硒作为一种简单，廉价，安全的辅助治疗艾滋病毒谱疾病。
Background: Despite findings that selenium supplementation may improve immune functioning, definitive evidence of its impact on human immunodeficiency virus (HIV) disease severity is lacking.Methods: High selenium yeast supplementation (200 mu g/d) was evaluated in a double-blind, randomized, placebo-controlled trial. Intention-to-treat analyses assessed the effect on HIV-1 viral load and CD4 count after 9 months of treatment. Unless otherwise indicated, values are presented as mean +/- SD.Results: Of the 450 HIV-1-seropositive men and women who underwent screening, 262 initiated treatment and 174 completed the 9-month follow-up assessment. Mean adherence to study treatment was good (73.0% +/- 24.7%) with no related adverse events. The intention-to-treat analyses indicated that the mean change (Delta) in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (Delta = 32.2 +/- 24.5 vs 0.5 +/- 8.8 mu g/L; P < .001), and greater levels predicted decreased HIV-1 viral load (P < . 02), which predicted increased CD4 count (P < . 04). Findings remained significant after covarying age, sex, ethnicity, income, education, current and past cocaine and other drug use, HIV symptom classification, antiretroviral medication regimen and adherence, time since HIV diagnosis, and hepatitis C virus coinfection. Follow-up analyses evaluating treatment effectiveness indicated that the nonresponding selenium-treated subjects whose serum selenium change was less than or equal to 26.1 mu g/L displayed poor treatment adherence (56.8% +/- 29.8%), HIV-1 viral load elevation (Delta = + 0.29 +/- 1.1 log(10) units), and decreased CD4 count (Delta = -25.8 +/- 147.4 cells/mu L). In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 mu g/L evidenced excellent treatment adherence (86.2% +/- 13.0%), no change in HIV-1 viral load (Delta = -0.04 +/- 0.7 log10 units), and an increase in CD4 count (Delta = + 27.9 +/- 150.2 cells/mu L).Conclusions: Daily selenium supplementation can suppress the progression of HIV-1 viral burden and provide indirect improvement of CD4 count. The results support the use of selenium as a simple, inexpensive, and safe adjunct therapy in HIV spectrum disease.