Selenium and aspirin in people living with HIV and AIDS in Nigeria.

Objectives: Aspirin and selenium have been shown in vitro and in vivo to inhibit HIV production through inhibition of the transcription factor, the nuclear factor kappa binding (NF-eB). The aim of this study was to examine the efficacy or otherwise of these drugs in people living with HIV and AIDS (PLWAS) in resource limited countries.

Patients And Methods: Consenting HAART-naive PLWAS with mean CD4 count of 256.8 +/- 67.6 cells/ul were recruited into the study. Pretherapy blood count, serum biochemistry, chest x-ray, urinary glucose and protein and microscopy and culture of both urine and stool were checked in all cases. Each patient was treated for six months and CD4 counts were repeated at the end of the study. Thirty two patients (23 (72%) females and nine (28%) males), aged 22-52 (median = 36) years were recruited. Twenty-three (72%) were randomised into selenium and aspirin (SAM) and nine (28%) into selenium (SM); multivitamin was added to each arm.

Results: Eighteen (56.2%) patients completed the study. Sixteen (88.9%) patients are already on HAART since the termination of the study; one absconded and one died of disease progression. Fourteen (43.8%) of the initial 32 patients dropped out (11 (78.6%) were lost to follow-up, two (14.3%) died and one (7.1%) opted for HAART before completing the study). The post-treatment CD4 count was 293.0 +/-102.2 cells/ml, compared to the pre-therapy mean of 256.8 +/- 67.6 cells/ul, an average rise of 36.2 cells/ul, the difference was not statistically significant (p = 0.059). The post-therapy mean weight was significantly higher than the pretherapy weight, 61.6+/-15.2 kg versus 60.0+/-14.3 kg (p = 0.015).

Conclusion: The SAM/SM combination regimen improved the quality of life of PLWAS, however, a greater number of patients and a longer period of follow up, are necessary to arrive at a more meaningful conclusion.