Plasma and Breast-Milk Selenium in HIV-Infected Malawian Mothers Are Positively Associated with Infant Selenium Status but Are Not Associated with Maternal Supplementation: Results of the Breastfeeding, Antiretrovirals, and Nutrition Study

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Flax, Valerie L.; Bentley, Margaret E.; Combs, Gerald F., Jr.; Chasela, Charles S.; Kayira, Dumbani; Tegha, Gerald; Kamwendo, Deborah D.; Daza, Eric J.; Fokar, Ali; & Kourtis, Athena P., et al. (2014). Plasma and Breast-Milk Selenium in HIV-Infected Malawian Mothers Are Positively Associated with Infant Selenium Status but Are Not Associated with Maternal Supplementation: Results of the Breastfeeding, Antiretrovirals, and Nutrition Study. American Journal of Clinical Nutrition, 99(4), 950-956. PMCID: PMC3953887

Abstract

BACKGROUND: Selenium is found in soils and is essential for human antioxidant defense and immune function. In Malawi, low soil selenium and dietary intakes coupled with low plasma selenium concentrations in HIV infection could have negative consequences for the health of HIV-infected mothers and their exclusively breastfed infants.
OBJECTIVE: We tested the effects of lipid-based nutrient supplements (LNS) that contained 1.3 times the Recommended Dietary Allowance of sodium selenite and antiretroviral drugs (ARV) on maternal plasma and breast-milk selenium concentrations.
DESIGN: HIV-infected Malawian mothers in the Breastfeeding, Antiretrovirals, and Nutrition study were randomly assigned at delivery to receive: LNS, ARV, LNS and ARV, or a control. In a subsample of 526 mothers and their uninfected infants, we measured plasma and breast-milk selenium concentrations at 2 or 6 (depending on the availability of infant samples) and 24 wk postpartum.
RESULTS: Overall, mean (+/-SD) maternal (range: 81.2 +/- 20.4 to 86.2 +/- 19.9 mug/L) and infant (55.6 +/- 16.3 to 61.0 +/- 15.4 mug/L) plasma selenium concentrations increased, whereas breast-milk selenium concentrations declined (14.3 +/- 11.5 to 9.8 +/- 7.3 mug/L) from 2 or 6 to 24 wk postpartum (all P < 0.001). Compared with the highest baseline selenium tertile, low and middle tertiles were positively associated with a change in maternal plasma or breast-milk selenium from 2 or 6 to 24 wk postpartum (both P < 0.001). With the use of linear regression, we showed that LNS that contained selenium and ARV were not associated with changes in maternal plasma and breast-milk selenium, but maternal selenium concentrations were positively associated with infant plasma selenium at 2 or 6 and 24 wk postpartum (P < 0.001) regardless of the study arm.
CONCLUSIONS: Selenite supplementation of HIV-infected Malawian women was not associated with a change in their plasma or breast-milk selenium concentrations. Future research should examine effects of more readily incorporated forms of selenium (ie, selenomethionine) in HIV-infected breastfeeding women. This trial was registered at clinicaltrials.gov as NCT00164736.

URL

http://dx.doi.org/10.3945/ajcn.113.073833

Reference Type

Journal Article

Year Published

2014

Journal Title

American Journal of Clinical Nutrition

Author(s)

Flax, Valerie L.
Bentley, Margaret E.
Combs, Gerald F., Jr.
Chasela, Charles S.
Kayira, Dumbani
Tegha, Gerald
Kamwendo, Deborah D.
Daza, Eric J.
Fokar, Ali
Kourtis, Athena P.
Jamieson, Denise J.
van der Horst, Charles M.
Adair, Linda S.

PMCID

PMC3953887

ORCiD

Adair - 0000-0002-3670-8073
Bentley - 0000-0002-1220-0208
Flax - 0000-0003-0200-3355
Daza - 0000-0002-8376-1600