Effect of selenium supplementation on HIV-1 RNA detection in breast milk of Tanzanian women
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CitationSudfeld, Christopher R., Said Aboud, Roland Kupka, Ferdinand M. Mugusi, and Wafaie W. Fawzi. 2014. “Effect of Selenium Supplementation on HIV-1 RNA Detection in Breast Milk of Tanzanian Women.” Nutrition 30 (9) (September): 1081–1084. doi:10.1016/j.nut.2014.01.011.
Selenium supplementation for HIV-infected women may increase genital shedding of HIV-1, but no studies have examined the effect on viral shedding in breast milk.
Research Methods and Procedures
HIV-infected pregnant women enrolled at 12–27 weeks gestation in a randomized, double-blind, placebo-controlled trial of daily selenium (200 μg as selenomethionine) had cell-free HIV-1 RNA quantified in breast milk at 4–9 weeks postpartum. All participants received high dose multivitamins containing vitamin B-complex, C, and E as standard of care.
The proportion of women with detectable (>50 copies/mL) HIV-1 RNA in breast milk appeared to be increased in the selenium group (36.4%) as compared to the placebo (27.5%) among the total cohort (n=420), but results were borderline statistically significant (RR: 1.32; 95% CI: 1.00–1.76; p=0.05). In secondary analyses, the proportion of women with detectable HIV-1 RNA in breast milk was significantly greater in the selenium group (37.8%) as compared to placebo (27.5%) among women who did not receive HAART (RR: 1.37; 95% CI: 1.03–1.82; p=0.03). This relationship was primarily due to a significant effect of selenium among primiparous women (RR: 2.24; 95% CI: 1.30–3.86; p<0.01), but not multiparous women (RR: 1.14; 95% CI: 0.81–1.59; p=0.54) (p-value for interaction=0.02). Too few women received HAART in this study (n=12) to establish the effect of selenium supplementation.
Selenium supplementation appears to increase HIV-1 RNA detection in breast milk among primiparous women not receiving HAART. Safety studies among pregnant women on HAART need to be conducted before providing selenium containing supplements.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:26863669
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