HIV patients have an increased risk of lacking both vitamin D and selenium

HIV, the virus that causes AIDS, is potentially life-threatening because it attacks central cells in the immune defense. It has also been documented that HIV patients have an increased risk of lacking vitamin D. This can be because of the disease itself, the combination therapy, lack of sun exposure, or other factors. Vitamin D is important for the immune defense, the bones, our mood, and numerous other functions. According to a new article published in MedicalNews Today, it is important to measure HIV patients’ blood levels of vitamin D and possibly give them high-dosed supplements to optimize levels of the nutrient. Earlier studies point to a link between the course of an HIV infections and the body’s selenium status.

HIV (human immunodeficiency virus) is a virus that causes AIDS (acquired immunodeficiency syndrome). HIV especially attacks macrophages that are part of the immune defense’s storm troops, and the T helper cells that play a key role in the specific immunity. When HIV attacks these cells, they are literally turned into “virus factories”. Once enough cells have become infected, the entire immune system comes to a grinding halt. This makes the body vulnerable to a host of opportunistic pathogens on the mucous membranes, ones that the immune system is normally able to defeat. This can result in e.g., fungal infections in the lungs, esophagus, and mouth, persistent herpes simplex, cryptococcus infection, and cardiac toxoplasmosis. In addition, the patient becomes increasingly susceptible to contamination from the surrounding environment.
There are two main categories of HIV. HIV-1 is the dominating type and causes AIDS. HIV is a so-called RNA virus with a formidable ability to mutate, which makes it particularly difficult to build immunity or to manufacture an effective vaccine.
The majority of patients die of AIDS-defining diseases within two years, unless they receive lifelong combination antiretroviral therapy, which is rather effective but does come with certain side effects. Experts generally agree that healthy eating habits, mental well-being, and physical activity are particularly important for HIV patients and their ability to maintain a strong immune system that can prevent infections. In addition, there is increased focus on vitamin D

Vitamin D’s role in the immune system and its other functions

Most cells in the body have vitamin D receptors because the nutrient controls different genes and a number of different functions. Vitamin D is also vital for the immune defense’s activity and ability to communicate, which is how we fight off infections. The process is supported by various antibiotic peptides in the airways and they also depend on vitamin D. Moreover, vitamin D prevents uncontrollable inflammation that can damage healthy tissue. The nutrient is also important for our bones, muscles, circulatory system, brain, and mood. Therefore, lack of vitamin D has far-reaching consequences for our health.

Why are HIV patients more likely to be vitamin D-deficient?

Researchers have observed that all patients with HIV-1 have insufficient levels of vitamin D in their blood. At least 30 percent of the patients are decidedly vitamin D-deficient. Lack of vitamin D may be a result of commonly known causes or a result of the disease itself.

Common causes of vitamin D-deficiency

• Lack of sunlight
• Lack of dietary vitamin D or poor nutrient absorption
• Dark skin
• Overweight
• Smoking
• Diabetes
• Liver and kidney diseases
• Ageing

Reasons why HIV patients are more likely to lack vitamin D

• Combination antiretroviral therapy
• Chronic inflammation
• Immune activation

HIV proteins affect enzymes that are involved in the synthesis of vitamin D

Vitamin D is considered a steroid hormone. Before it is able to function as active vitamin D in the cells, it must first be converted enzymatically in two independent processes. The form of vitamin D that we synthesize in our skin in response to sun exposure (UVB), or which we get from supplements, is not biologically active. The first enzymatic conversion step takes place inside the liver, and when vitamin D is needed in its active form, it is converted again in the second enzyme process that takes place in the kidneys, the immune cells, and in other cells. Apparently, HIV-1 affects the way in which the body synthesizes vitamin D. This is because HIV is able to increase the production of proinflammatory cytokines that prevent the body from producing active vitamin D. Different therapies such as Efavirenz and Tenofovir are also known to affect the body’s vitamin D synthesis. Not only can this damage the immune system, it can also have a negative impact on the bones, muscles, blood sugar, mood, and various other things.

Giving vitamin D to HIV patients

A blood sample can easily show if an HIV patient lacks vitamin D. If the patient takes antiretroviral medication that lowers levels of vitamin D in the body it may be worth considering a different type of therapy.
A review article from 2019 that includes 29 clinical studies shows that vitamin D supplementation effectively restores vitamin D levels in HIV patients that have been diagnosed with a vitamin D deficiency. In most cases, doses between 100-175 micrograms per day were used. In patients with severe vitamin D deficiency, a daily dose of 175 micrograms restored blood levels of the vitamin D in 80 percent of the patients.
Once blood levels of vitamin D are sufficiently high, it is recommended to keep them there. According to the new article in MedicalNewsToday, HIV patients are advised to take 100 micrograms of vitamin D each day. This dose is substantially higher than the official recommendations yet compares to the European Food Safety Authority’s safe upper intake level, or the amount of vitamin D that a person with white skin is able to synthesize on a normal day during summer.
Most of the studies that looked at the link between HIV infections and vitamin D had a relatively short follow-up period. Therefore, more studies are needed in order to determine the long-term effect of giving high-dosed vitamin D supplements to HIV patients.
Not only HIV patients but everyone should aim to have optimal vitamin D levels in their blood throughout life. Vitamin D is lipid-soluble so the best way to help the body absorb and utilize the nutrient is by taking it in a vegetable oil solution in soft gelatin capsules.

Selenium’s role in HIV and the use of relevant supplements

Selenium is vital for the immune defense and it prevents viruses from mutating. Selenium supports some powerful antioxidants that protect cells and tissues against oxidative stress. Back in 1997, scientists discovered a link between the selenium content in agricultural soil and AIDS mortality in different American states. During the same period and before the advent of effective combination antiretroviral therapies, professor Marianna Baum from Miami University demonstrated that the more selenium an HIV-positive person has in the blood, the more likely that person is to live longer, despite having the disease.
For three and a half years, Baum and her team of scientists studied 125 HIV-infected men and women and took different blood samples from them twice a year. Two variables could safely predict which of the HIV-positive patients would die: The drop in T helper cell count, and a drop in blood levels of selenium. The reduction of selenium levels turned out to the best safest predictor.
Ever since, multiple studies have shown that supplementing with 200 micrograms of selenium daily can counteract the reduced T helper cell count, thereby preventing the disease from developing into full-blown AIDS. These details are described in a systematic review article that is published in Clinical Nutrition Espen (2019).
If you take selenium yeast with many different selenium species you get the same natural variety of selenium types as you would get from eating a balanced diet with many different selenium sources. Make sure to choose a selenium supplement with documented bioavailability. The European Food Safety Authority (EFSA) has established a 300 micrograms per day safe upper intake level for selenium.

References

Beth Sissons. HIV and vitamin D deficiency: What is the link? MedicalNewsToday. August 2021

Natalia Alvarez et al. The Potential protective Role of Vitamin D Supplementation on HIV-1 Infection. Front Immunol 25 September 2019

Debra Sullivan. What are the health benefits of vitamin D? MedicalNewsToday 2019

Cowgill U.M. The distribution of selenium and mortality owing to acquired immune deficiency syndrome in the continental United States. Biol Trace Elem 1997

Basilua Andre Muzembo et al. selenium supplementation in HIV-infected individuals: A systematic review of randomized controlled trials. Clinical Nutrition Espen. 2019

Human immundefektvirus - Wikipedia, den frie encyklopædi