SERUM SELENIUM, PLASMA GLUTATHIONE (GSH) AND ERYTHROCYTE GLUTATHIONE-PEROXIDASE (GSH-PX)-LEVELS IN ASYMPTOMATIC VERSUS SYMPTOMATIC HUMAN IMMUNODEFICIENCY VIRUS-1 (HIV-1)-INFECTION

Objectives: Antioxidant defense status was investigated in HIV-infecte d patients by measuring serum selenium, erythrocyte glutathione peroxi dase (GSH-Px) activity, plasma thiol (-SH) and glutathione (GSH) conce ntrations along with the assessment of the clinical stage and surrogat e 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 AI DS defining events). The patients were classified into three stages of the disease, I, II and III according to the 1993 Centers For Disease Control (CDC) classification system for HIV-infection. GSH-Px activiti es, plasma SH and plasma GSH concentrations were determined in a subse t of 24 patients at stage I and 12 patients at stage III with an activ e AIDS-defining disease. Results: Mean serum selenium levels were lowe r in CDC stage II (68.7 +/- 20.9 mu g/l; P < 0.01; n = 34) and stage I II (51.4 +/- 14.7 mu g/l; P < 0.01; n = 37) HIV-infected patients than in healthy subjects (89.2 +/- 20.9 mu g/l; n = 72) and stage I patien ts (82.3 +/- 20.5; mu g/l; n = 33). Serum selenium levels were positiv ely correlated with CD4-count (r = 0.42; P < 0.001; n = 104) and inver sely with levels of soluble tumor necrosis factor receptors type II (r = -0.58; P < 0.01; n = 35), neopterin (r = -0.5; P < 0.001; n = 80) a nd beta 2-microglobulin (r = -0.4; P < 0.001; n = 94). Hepatitis C vir us (HCV) and HIV-coinfected patients at CDC stages I and II showed mar kedly lower selenium concentrations compared to HIV-infected patients without concomitant HCV-infection. Serum selenium and GSH-Px activity in hospitalized AIDS patients was significantly lower as compared to a symptomatic patients and healthy subjects, whereas plasma SH and GSH c oncentrations were lower in both, asymptomatic -and AIDS-patients, tha n in the controls. Conclusion: The results show that stages I-III of H IV-disease are characterized by significant impairments of antioxidati ve defenses provided by selenium, GSH-Px, SH-groups and GSH.