Selenium supplementation in HIV-infected individuals: A systematic review of randomized controlled trials

Background & aim: HIV infection has been linked to selenium deficiency which, in turn, is thought to be associated with a high risk of tuberculosis and mortality in HIV-infected patients. Furthermore, several trials have reported the beneficial effects of selenium supplementation in patients with HIV. However, the evidence remains inconclusive. Our study aimed to investigate whether daily selenium supplementation in patients infected with HIV delays the progression of HIV infection. Methods: A systematic review was performed using EMBASE and Medline databases from January 2000 to June 2018. We included randomized clinical trials in adults comparing selenium with placebo and reporting outcomes including its effect on HIV viral load and cluster of differentiation 4 cell count (CD4). Results: Six out of the 507 retrieved articles that met the inclusion criteria were used in this review. Reviewed studies show that daily supplementation with 200 μg selenium may improve the rate of cluster of differentiation 4 (CD4) count. The length of selenium supplementation and follow-up varied from 9 to 24 months. Supplements were well tolerated in all reviewed studies. Whether daily selenium supplementation in HIV-infected persons suppresses HIV-infection requires further investigation as existing data are heterogeneous. Conclusions: We found some clinical evidence that selenium supplementation can delay CD4 decline in HIV-infected patients, thus prolonging the onset of AIDS. However, we did not find quantifiable evidence that selenium supplementation suppresses or reduces HIV viral load.