Correlation of selenium and zinc levels to antiretroviral treatment outcomes in Thai HIV-infected children without severe HIV symptoms

T Bunupuradah, S Ubolyam, R Hansudewechakul, P Kosalaraksa, C Ngampiyaskul, S Kanjanavanit, J Wongsawat, W Luesomboon, S Pinyakorn, S Kerr, J Ananworanich, S Chomtho, J van der Lugt, N Luplertlop, K Ruxrungtham, T Puthanakit, PREDICT study group, Praphan Phanuphak, David A Cooper, John Kaldor, Chhi Vun, Saphonn Vonthanak, Kiat Ruxrungtham, Carlo Giaquinto, Mark Cotton, Rangsima Lolekha, Virat Sirisanthana, Kulkanya Chokephaibulkit, Piyarat Suntarattiwong, Paul Volberding, Shrikant Bangdiwala, Kruy Lim, N M Samuel, David Schoenfeld, Annette Sohn, Suniti Solomon, Panpit Suwangool, Ruotao Wang, Fujie Zhang, Laurie Zoloth, Dennis O Dixon, Lawrence Fox, Akinlolu O Ojumu, Jane E Bupp, Michael Ussery, Neal T Wetherall, Pim Brouwers, Lynne M Mofenson, Matthew Law, William T Shearer, Victor Valcour, Rober Paul, Kovit Pattanapanyasat, Natthaga Sakulploy, Janet M McNicholl, Wendy Snowden, Navdeep K Thoofer, Manuel Distel, Annette S Meints, Adawan Methasate, Matei Popescu, Aeumporn Srigritsanapol, Suchai Kitsiripornchai, T Bunupuradah, S Ubolyam, R Hansudewechakul, P Kosalaraksa, C Ngampiyaskul, S Kanjanavanit, J Wongsawat, W Luesomboon, S Pinyakorn, S Kerr, J Ananworanich, S Chomtho, J van der Lugt, N Luplertlop, K Ruxrungtham, T Puthanakit, PREDICT study group, Praphan Phanuphak, David A Cooper, John Kaldor, Chhi Vun, Saphonn Vonthanak, Kiat Ruxrungtham, Carlo Giaquinto, Mark Cotton, Rangsima Lolekha, Virat Sirisanthana, Kulkanya Chokephaibulkit, Piyarat Suntarattiwong, Paul Volberding, Shrikant Bangdiwala, Kruy Lim, N M Samuel, David Schoenfeld, Annette Sohn, Suniti Solomon, Panpit Suwangool, Ruotao Wang, Fujie Zhang, Laurie Zoloth, Dennis O Dixon, Lawrence Fox, Akinlolu O Ojumu, Jane E Bupp, Michael Ussery, Neal T Wetherall, Pim Brouwers, Lynne M Mofenson, Matthew Law, William T Shearer, Victor Valcour, Rober Paul, Kovit Pattanapanyasat, Natthaga Sakulploy, Janet M McNicholl, Wendy Snowden, Navdeep K Thoofer, Manuel Distel, Annette S Meints, Adawan Methasate, Matei Popescu, Aeumporn Srigritsanapol, Suchai Kitsiripornchai

Abstract

Background/objectives: Deficiencies in antioxidants contribute to immune dysregulation and viral replication. To evaluate the correlation of selenium (Se) and zinc (Zn) levels on the treatment outcomes in HIV-infected children.

Subjects/methods: HIV-infected Thai children 1-12 years old, CD4 15-24%, without severe HIV symptoms were included. Se and Zn levels were measured by graphite furnace atomic absorption spectrometry at baseline and 48 weeks. Deficiency cutoffs were Se <0.1 μmol/l and Zn <9.9 μmol/l. Serum ferritin and C-reactive protein (CRP) were measured every 24 weeks. No micronutrient supplement was prescribed.

Results: In all, 141 children (38.3% male) with a median (interquartile range (IQR)) age of 7.3 (4.2-9.0) years were enrolled. Median baseline CD4% was 20%, HIV-RNA was 4.6 log(10)copies/ml. At baseline, median (IQR) Se and Zn levels were 0.9 (0.7-1.0) μmol/l and 5.9 (4.8-6.9) μmol/l, respectively. None had Se deficiency while all had Zn deficiency. Over 48 weeks, 97 initiated antiretroviral therapy (ART) and 81% achieved HIV-RNA <50 copies/ml with 11% median CD4 gain. The mean change of Se was 0.06 μmol/l (P=0.003) and Zn was 0.42 μmol/l (P=0.003), respectively. By multivariate analysis in children who received ART, predictors for greater increase of CD4% from baseline were lower baseline CD4% (P<0.01) and higher baseline Zn level (P=0.02). The predictors for greater decrease of HIV-RNA from baseline were higher baseline HIV-RNA and higher ferritin (both P<0.01). No association of CRP with the changes from baseline of CD4% or HIV-RNA was found.

Conclusion: In HIV-infected Thai children without severe immune deficiency who commenced ART, no correlation between Se and ART treatment outcomes was found. Higher pre-ART Zn levels were associated with significant increases in CD4% at 48 weeks.

Trial registration: ClinicalTrials.gov NCT00234091.

Conflict of interest statement

Financial disclosure and Conflict of interest

All authors declare no conflict of interest and that member of their immediate families do not have a financial interest in or arrangement with any commercial organization that may have a direct interest in the subject matter of this article.

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Source: PubMed

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