Mortality risk in selenium-deficient HIV-positive children

Area of Science:

• Pediatric Immunology
• Nutritional Science
• Epidemiology

Background:

• Human Immunodeficiency Virus type 1 (HIV-1) infection in children presents significant challenges to immune status and overall survival.
• Nutritional factors are increasingly recognized for their potential impact on disease progression in pediatric HIV-1.
• Understanding specific nutritional contributions is crucial for improving outcomes in affected children.

Purpose of the Study:

• To investigate the independent role of specific nutritional factors in the progression of HIV-1 disease and survival among infected children.
• To identify key nutritional markers associated with mortality and disease advancement in pediatric HIV-1.

Main Methods:

• A cohort of 24 symptomatic, perinatally HIV-1-exposed children was followed for 5 years.
• Immune status (CD4 cell count) and nutritional status (serum albumin, plasma trace elements like selenium) were assessed.
• Cox proportional hazards regression models analyzed the relationship between nutritional factors, immune status, and survival, considering antiretroviral treatment.

Main Results:

• Twelve children died from HIV-1 related causes during the study period.
• Low plasma selenium levels (RR = 5.96) and CD4 cell counts below 200 (RR = 7.05) were independently significant predictors of mortality.
• Children with low selenium levels died at a younger age, indicating accelerated disease progression.

Conclusions:

• Low plasma selenium levels are an independent predictor of mortality in pediatric HIV-1 infection.
• Reduced selenium levels are associated with more rapid HIV-1 disease progression in children.
• Monitoring and potentially supplementing selenium may be important for improving survival and managing disease progression in pediatric HIV-1.