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Editor's Correspondence
July 23, 2007

Does Selenium Supplementation Slow Progression of HIV? Potentially Misleading Presentation of the Results of a Trial

Arch Intern Med. 2007;167(14):1555-1556. doi:10.1001/archinte.167.14.1555-c

Hurwitz et al1 present the results of a landmark placebo-controlled trial in the United States on the impact of a single daily selenium supplement on human immunodeficiency virus (HIV) disease progression (as measured by HIV viral load and CD4 cell count after 9 months). Of the participants, 73% were receiving antiretroviral therapy (ART) (76% in those allocated to selenium and 72% in those allocated to placebo). Although only 174 of 262 participants (66%) who initiated treatment were available for follow-up at 9 months and mean adherence to study treatment was estimated to have been 73% using a computerized electronic medication-monitoring cap and 81% by pill counts, follow-up rates and adherence were similar in the selenium-supplemented and placebo groups. The trial showed that at the 9-month follow-up, having been allocated to the selenium supplementation group was associated with a substantial increase in serum selenium concentration compared with those allocated to placebo. There were no adverse events reported that were related to the study supplement. So far, so good.

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