Effect of selenium supplementation on HIV-1 RNA detection in breast milk of Tanzanian women

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https://doi.org/10.1016/j.nut.2014.01.011Metadata
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Sudfeld, 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.Abstract
ObjectiveSelenium 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.
Results
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.
Conclusions
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.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127095/Terms of Use
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