AEGiS-13IAC: Selenium deficiency is associated with shedding of HIV-1 infected cells in the female genital tract.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Selenium deficiency is associated with shedding of HIV-1 infected cells in the female genital tract.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrA226)

Baeten J, Mostad S, Hughes M, Overbaugh J, Bankson D, Mandaliya K, Ndinya-Achola J, Kreiss J
J. Baeten, University of Washington, P.O. Box 91276, Mombasa, Kenya, Tel.: +254 11 22 6249, Fax: +254 11 47 4055, E-mail: jbaeten@u.washington.edu

BACKGROUND: Nutritional deficiencies are common in HIV-1 disease and may play a role in HIV-1 transmission. The objective of this study was to assess the relationship between selenium deficiency and vaginal or cervical shedding of HIV-1 infected cells.

METHODS: Vaginal and cervical swab specimens from 318 HIV-1 seropositive women in Mombasa, Kenya were tested for the presence of HIV-1 DNA by PCR. Multivariate logistic regression models, adjusting for CD4 count and vitamin A deficiency, were used.

RESULTS: Selenium deficiency was observed in 11% of the study population. There was a trend for an association between selenium deficiency and vaginal shedding (AOR 2.1, 95% CI 0.9-5.2, p = 0.09). Predictors of shedding with strong local effects on the genital tract mucosa (e.g., oral contraceptive use, depot medroxyprogesterone acetate use, gonorrhea infection, vaginal candidiasis) masked associations between selenium deficiency and shedding which became apparent in stratified analyses. Among women who did not use oral contraceptives and who did not have vaginal candidiasis, selenium deficiency was significantly associated with vaginal shedding (AOR 2.9, 95% CI 1.0-8.8, p = 0.05). Effect modification was also observed in the relationship between selenium deficiency and cervical shedding, with a significant association seen only among those women who were not using oral contraceptive pills or depot medroxyprogesterone acetate and who did not have Neisseria gonorrhoeae infection (AOR 2.8, 95% CI 1.1-7.0, p = 0.0 2).

CONCLUSIONS: We found selenium deficiency to be associated with a nearly 3-fold increased likelihood of shedding of genital mucosal HIV-1 DNA, suggesting that deficiency may increase the infectiousness of women with HIV-1. Nutritional interventions to prevent HIV-1 transmission warrant investigation.

Keywords: AEGIS, HIV-1, Genitalia, Female, HIV Infections, CD4 Lymphocyte Count, Vagina, Vitamin A Deficiency, Polymerase Chain Reaction, Metabolic Diseases, Kenya, Human, Female, deficiency
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MoOrA226