Multivitamins plus Selenium for Slowing HIV Progression?

The WHO now recommends that all HIV-infected people with a CD4 count <500 cells/mm³ receive antiretroviral therapy (ART). That goal is currently difficult to achieve, so alternative strategies to delay disease progression are needed. Given that micronutrient deficiency occurs early in the course of HIV infection, U.S. investigators randomized 878 ART-naive adults in Botswana with HIV subtype C and early disease (defined as a CD4 count >350 cells/mm³) to receive placebo, only multivitamins (B vitamins plus C and E), only selenium, or multivitamins plus selenium as a single pill. At baseline, the median CD4 count was 420 cells/mm³ (33% had a count ≥500 cells/mm³), and the median viral load was 4.14 log₁₀ copies/mL.

During a median 2 years of f…