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Multivitamin-Selenium Combo May Delay Ill Health, Mortality From AIDS When Antiretrovirals Are Unavailable

January 15, 2014

This article was reported by Harvard School of Public Health News.

Harvard School of Public Health (HSPH) News reported on a study of a special multivitamin with selenium that could slow progression to ill health significantly in HIV-positive individuals. HSPH researchers studied the effect of multivitamins on the health of HIV-positive persons since they tend to have deficiencies in micronutrients such as B vitamins, vitamin C and E, thiamin, riboflavin, niacin, and folic acid. The lack of these substances may hasten disease. Also, the trace element selenium helps support the immune system.

The researchers, including Richard Marlink, executive director of the HSPH AIDS Initiative and the Bruce A. Beal, Robert L. Beal, and Alexander S. Beal Professor of the Practice of Public Health at HSPH, followed up on a 2004 Tanzanian study. The Tanzanian study suggested that HIV-positive pregnant women who took a certain multivitamin remained healthier longer than those who did not. These women were in different stages of HIV before antiretroviral treatment (ART) was available to them. The researchers conducted a new randomized, controlled study from 2004 to 2009 in Botswana with 878 HIV-positive women who were not pregnant and men who had never been treated with ART. The researchers divided participants into four groups; each group received either a multivitamin alone, selenium alone, a combination of multivitamins plus selenium, or placebo.

Results showed that participants who received the multivitamin with selenium had an approximately 50-percent reduced risk of getting sick or dying from AIDS during the 24 months of study, and they were more likely to have higher CD4 counts. Marlink warned that multivitamins should not be considered a substitute for ART for persons with low CD4 counts, as ART is very effective in maintaining health and preventing AIDS for a very long time. He explained that depending on the African country, only approximately half of the need for ART has been met, so anything else that can be done for the HIV-positive individuals who do not yet have access to ART is helpful.

The full report, "Effect of Micronutrient Supplementation on Disease Progression in Asymptomatic, Antiretroviral-Naive, HIV-Infected Adults in Botswana: A Randomized Clinical Trial," was published in the Journal of the American Medical Association (2013; 310(20):2154-2163 doi:10.1001/jama.2013.280923).

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