Serum selenium, plasma glutathione (GSH) and erythrocyte glutathione peroxidase (GSH-Px)-levels in asymptomatic versus symptomatic human immunode®ciency virus-1 (HIV-1)-infection

Objectives: Antioxidant defense status was investigated in HIV-infected patients by measuring serum selenium, erythrocyte glutathione peroxidase (GSH-Px) activity, plasma thiol (-SH) and glutathione (GSH) concentrations along with the assessment of the clinical stage and surrogate markers of HIV-disease. Design, setting and subjects: Serum selenium levels were determined cross-sectionally in 104 sequentially selected HIV-infected patients (83 outpatients and 21 patients with ongoing AIDS de®ning events). The patients were classi®ed into three stages of the disease, I, II and III according to the 1993 Centers For Disease Control (CDC) classi®cation system for HIV-infection. GSH-Px activities, plasma SH and plasma GSH concentrations were determined in a subset of 24 patients at stage I and 12 patients at stage III with an active AIDS-de®ning disease. Results: Mean serum selenium levels were lower in CDC stage II (68.7 20.9 mg/l; P< 0.01; nˆ 34) and stage III (51.4 14.7 mg/l; P< 0.01; nˆ 37) HIV-infected patients than in healthy subjects (89.2 20.9 mg/l; nˆ 72) and stage I patients (82.3 20.5; mg/l; nˆ 33). Serum selenium levels were positively correlated with CD4count (rˆ 0.42; P< 0.001; nˆ 104) and inversely with levels of soluble tumor necrosis factor receptors type II (rˆ 7 0.58; P< 0.01; nˆ 35), neopterin (rˆ70.5; P< 0.001; nˆ 80) and b2-microglobulin (rˆ70.4; P< 0.001; nˆ 94). Hepatitis C virus (HCV) and HIV-coinfected patients at CDC stages I and II showed markedly lower selenium concentrations compared to HIV-infected patients without concomitant HCVinfection. Serum selenium and GSH-Px activity in hospitalized AIDS patients was signi®cantly lower as compared to asymptomatic patients and healthy subjects, whereas plasma SH and GSH concentrations were lower in both, asymptomatic -and AIDS-patients, than in the controls. Conclusion: The results show that stages I±III of HIV-disease are characterized by signi®cant impairments of antioxidative defenses provided by selenium, GSH-Px, SH-groups and GSH. Sponsorship: Department of General Internal Medicine, University of Bonn, Germany. Descriptors: serum selenium; glutathione peroxidase; plasma thiols; glutathione; HIV-infection; AIDS.