RELATIONSHIP OF TRACE-ELEMENT, IMMUNOLOGICAL MARKERS, AND HIV-1 INFECTION PROGRESSION

Trace elements (selenium, zinc, copper), beta(2) microglobulin levels, CD4, and CD8 cell counts have been determined in 80 HIV1 seropositive patients. The study group consisted of 19 females and 61 males with age mean of 35 +/- 10 yr, at stage IV of infection (CDC-Atlanta classification) and treated by AZT. No severe renal or liver diseases or hypoalbuminemia were observed in this group. Se values were significantly lower than in normal adults, 48.3 +/- 17 mu g/L vs 71 +/- 12 mu g/L; Zn was moderately diminished, 1 +/- 0.2 mg/L vs 1.2 +/- 0.2 mg/L, whereas copper values were in the normal range, 1.2 +/- 0.3 mg/L vs 1.1 +/- 0.5 mg/L. Se or Zn deficiency was found in 60 and 30 subjects, respectively. Blood Se and Zn decreases were associated in 23 patients. Moreover, all patients showed higher beta(2) microglobulin values than the upper normal limit of 2.4 mg/L. Negative correlations were found between Zn and beta 2 microglobulin (p < 0.005) and between Se and beta(2) microglobulin (p < 0.05). Moreover, there was a positive correlation between Se and Zn values (p < 0.05). Nineteen subjects died 1 yr later (group I), and 61 remained alive (group II). With respect to the clinical evolution, a significant difference between both groups was found in Se and beta 2 microglobulin levels as well as in CD4 cell counts. The correlations previously observed persisted in group II, whereas no correlation was noted in group I. In addition, the patients of group I had significantly lower Se values, which were below 30 mu g/L in 10 cases. These results confirm the prevalence of abnormalities in Se and Zn levels and their relationships with nonspecific markers of immune system activity in more advanced HIV disease. Impairment of trace element status and mainly Se status appeared, at least partially, to reflect the disease activity/progression and subsequently the immune dysregulation.