Document 0136
 DOCN  M9470136
 TI    Selenium deficiency in HIV infection and the acquired immunodeficiency
       syndrome (AIDS).
 DT    9409
 AU    Dworkin BM; Section of Nutrition, New York Medical College, Valhalla
       10595.
 SO    Chem Biol Interact. 1994 Jun;91(2-3):181-6. Unique Identifier : AIDSLINE
       MED/94251844
 AB    Selenium is required for activity of the enzyme glutathione peroxidase,
       and selenium deficiency may be associated with myopathy, cardiomyopathy
       and immune dysfunction including oral candidiasis, impaired phagocytic
       function and decreased CD4 T-cells. We assessed selenium status in 12
       patients with AIDS compared to normals and found significantly low
       plasma and red blood cell levels. Plasma selenium in AIDS was 0.043 +/-
       0.01 microgram/ml vs 0.095 +/- 0.016 in controls (P < 0.001). Selenium
       status correlated with serum albumin (r = 0.77; P < 0.001) and 60% had
       documented GI malabsorption as determined by abnormal D-Xylose tests. In
       a subsequent study blood selenium and glutathione peroxidase were
       diminished in 12 AIDS and 8 ARC patients compared with normals (all P <
       0.001). For glutathione peroxidase the mean levels were decreased by 45%
       in AIDS and 27% in ARC versus controls (P < 0.001). Both plasma selenium
       and glutathione peroxidase significantly correlated with total
       lymphocyte counts (r = 0.65; P < 0.001; glutathione peroxidase and
       lymphocyte counts). This occurred in both homosexuals and drug users
       with AIDS and irrespective of the presence or absence of diarrhea or GI
       malabsorption. To determine if tissue levels of selenium were also
       depleted we studied cardiac selenium levels in autopsy AIDS hearts
       compared to age and sex matched controls. Cardiac selenium in AIDS was
       0.327 +/- 0.082 micrograms/g dry weight versus 0.534 +/- 0.184 in
       controls (P < 0.01). Two cases had histologic cardiomyopathy
       pathologically consistent with the cardiomyopathy described in Keshan
       disease associated with low selenium blood levels. To further assess
       mechanisms of nutrient and selenium deficiency in AIDS we studied
       dietary intake in outpatients and inpatients with various stages of HIV
       infection. Inadequate selenium intake based on a computer (Nutritionist
       3) analysis of 72 h diet records was present in only 17% of clinically
       stable HIV positive outpatients and 71% of inpatients with AIDS.
       Conclusions: Selenium deficiency is common in HIV positive patients as
       documented by low plasma and red blood cell levels of selenium,
       diminished activity of glutathione peroxidase, and low cardiac selenium
       levels in AIDS hearts. Patients with AIDS tend to have more severe
       deficits than those with earlier stages of HIV infection. The selenium
       deficit in blood does correlate with serum albumin levels and total
       lymphocyte counts. Poor dietary intake and malabsorption could lead to
       this condition which has important implications for both cardiac and
       immune functions in HIV positive patients.
 DE    Acquired Immunodeficiency Syndrome/BLOOD/DRUG THERAPY/*METABOLISM
       Female  Glutathione Peroxidase/BLOOD  Human  HIV Infections/BLOOD/DRUG
       THERAPY/*METABOLISM  Male  Myocardium/METABOLISM
       Selenium/ADMINISTRATION & DOSAGE/BLOOD/*DEFICIENCY/THERAPEUTIC  USE
       JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).