HIV Disease, Drug Abuse, & Nutrient Therapy in Botswana

非洲博茨瓦纳是世界上艾滋病毒感染率最高的国家。此外，一个新兴的 世界上这一地区的药物滥用问题可能会导致免疫抑制和 营养状况，这反过来又促进艾滋病毒疾病的发展。此应用程序基于我们的非洲 研究表明，复合维生素补充剂显著增加孕妇的CD4计数 随着时间的推移，我们的美国研究表明，硒是艾滋病毒死亡率的有力预测因子，而且 补充硒可以延缓HIV疾病的进展。此应用程序的总体目标是 确定补充多种维生素和硒是否可以改善免疫功能和 延长博茨瓦纳感染艾滋病毒成人的艾滋病或死亡率的时间。我们将从以下人员中招募828人 博茨瓦纳的筛查诊所由合作的哈佛艾滋病研究所管理。患有CD4的参与者 Count&gt；350将随机分为4组：多种维生素和 或单独服用多种维生素，或单独服用硒，或服用安慰剂，为期24个月。这样做的具体目的是 建议是1)研究多种维生素和硒的组合是否比 在改善免疫功能方面，单一的复合维生素或单一的硒。2)调查 在改善免疫功能方面，复合维生素补充剂是否优于安慰剂。 3)探讨在改善免疫功能方面，硒是否优于安慰剂。4) 评估药物滥用如何影响艾滋病毒感染者的营养状况和艾滋病毒疾病进展，以及 女人。这项拟议的调查将确定营养疗法提高免疫力的有效性。 在博茨瓦纳，艾滋病毒的功能和缓慢的疾病进展。因为抗逆转录病毒疗法并不容易 这项研究适用于非洲大多数国家感染艾滋病毒的成年人，可能会提供另一种方法 来延缓艾滋病毒的发展。

The country of Botswana, Africa, has the highest rates of HIV infection in the world. Moreover, an emerging drug abuse problem in this part of the world may contribute to immune suppression and to the decline of nutritional status, which in turn facilitates HIV disease progression. This application is based on our African studies indicating that multivitamin supplementation significantly increased CD4 count in pregnant women over time, and our US studies showing that selenium is a powerful predictor of HIV mortality and that selenium supplementation slows HIV disease progression. The overall goal of this application is to determine whether supplementation with multivitamins and selenium can improve immune function and prolong time to AIDS or mortality in HIV infected adults in Botswana. We will recruit 828 participants from the Botswana screening clinics managed by the collaborating Harvard AIDS Institute. Participants with CD4 count > 350 will be randomized into a factorial design with 4 groups: combination of multivitamins with selenium, or multivitamins alone, or selenium alone, or placebo, for 24 months. The specific aims of this proposal are 1) To investigate whether the combination of multivitamins and selenium is preferable to either multivitamins alone or selenium alone with respect to improving immune function. 2) To investigate whether multivitamin supplementation is preferable to placebo with respect to improving immune function. 3) To investigate whether selenium is preferable to placebo with respect to improving immune function. 4) To assess how drug abuse affects nutritional status and HIV disease progression in HIV infected men and women. This proposed investigation will determine the efficacy of nutrient therapy to improve immune function and slow HIV disease progression in Botswana. Since antiretroviral therapies are not readily available to HIV infected adults in most countries in Africa, this study may provide an alternative approach to retard HIV progression.