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Open Access Research article

Low serum albumin and the acute phase response predict low serum selenium in HIV-1 infected women

Paul K Drain1, Jared M Baeten2, Julie Overbaugh7, Mark H Wener234, Daniel D Bankson346, Ludo Lavreys59, Kishorchandra Mandaliya8, Jeckoniah O Ndinya-Achola9 and R Scott McClelland259*

Author Affiliations

1 School of Medicine, University of Washington, 1959 NE Pacific, A-300 Health Sciences, Box 356340, Seattle, WA 98105, USA

2 Department of Medicine, University of Washington, 1959 NE Pacific, A-300 Health Sciences, Box 356340, Seattle, WA 98105, USA

3 Department of Laboratory Medicine, University of Washington, 1959 NE Pacific, A-300 Health Sciences, Box 356340, Seattle, WA 98105, USA

4 Clinical Nutrition Research Unit Laboratory Core, University of Washington, 1959 NE Pacific, A-300 Health Sciences, Box 356340, Seattle, WA 98105, USA

5 Department of Epidemiology, University of Washington, 1959 NE Pacific, A-300 Health Sciences, Box 356340, Seattle, WA 98105, USA

6 Veterans Affairs Puget Sound Health Care System, Seattle, USA

7 Divisions of Human Biology and Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA

8 Department of Pathology, Coast Provincial General Hospital, Mombasa, Kenya

9 Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya

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BMC Infectious Diseases 2006, 6:85  doi:10.1186/1471-2334-6-85

Published: 19 May 2006

Abstract

Background

Low serum selenium has been associated with lower CD4 counts and greater mortality among HIV-1-seropositive individuals, but most studies have not controlled for serum albumin and the presence of an acute phase response.

Methods

A cross-sectional study was conducted to evaluate relationships between serum selenium concentrations and CD4 count, plasma viral load, serum albumin, and acute phase response markers among 400 HIV-1-seropositive women.

Results

In univariate analyses, lower CD4 count, higher plasma viral load, lower albumin, and the presence of an acute phase response were each significantly associated with lower serum selenium concentrations. In multivariate analyses including all four of these covariates, only albumin remained significantly associated with serum selenium. For each 0.1 g/dl increase in serum albumin, serum selenium increased by 0.8 μg/l (p < 0.001). Women with an acute phase response also had lower serum selenium (by 5.6 μg/l, p = 0.06).

Conclusion

Serum selenium was independently associated with serum albumin, but not with CD4 count or plasma viral load, in HIV-1-seropositive women. Our findings suggest that associations between lower serum selenium, lower CD4 count, and higher plasma viral load may be related to the frequent occurrence of low serum albumin and the acute phase response among individuals with more advanced HIV-1 infection.