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Rethinking health Selenium Conquers AIDS? Sam Burcher reports on a nutritional hypothesis with possible implications for prevention and treatment of the global pandemic During the last decade, research has indicated an important geographical link between regions of selenium deficient soils and peak incidences of HIV/AIDS infection. AIDS disease appears to involve a slow and progressive decline in levels of the trace element selenium (Se) in the blood along with CD4 cells, which are both independent predictors of mortality. AIDS infection in Africa has reached pandemic proportions with over a quarter of the population said to be suffering from the disease in some areas, although there is debate over how the World Health Organization (WHO) has extrapolated their statistics (see "African Aids epidemic?" SiS 22). Figures from Harvard in the United States put infection rates as follows: Zimbabwe 25.84%, Botswana 25.10%, Zambia 19.07%, South Africa 12.91%, Côte D'Ivoire 10.06%, Tanzania 9.42%, Ethiopia 9.31%, and Congo 4.31%. But Senegal in West Africa has the lowest numbers of AIDS prevalence at 1.77% in the general population, and 0.5% in antenatal clinic attendees along with the highest levels of selenium-enriched soil. Geologically, Senegal is situated in the desiccated or dried up Cretaceous and early Eocene Sea, and the land is formed from sedimentary rocks from dissolved minerals in the evaporating seawater. Consequently, calcium phosphates are one of the country's mined mineral products used for fertilizers, and are derived from the selenium rich phosphorite. Senegal can also claim the lowest level of cancers on the African continent. Geographical disease pattern analogies made by Prof E.W. Taylor, University of Georgia, suggest that AIDS, Karposi Sarcoma and cancers are rife in regions of selenium depleted soils and that this has further implications in the seemingly unstoppable spread of AIDS incidence worldwide. Depleted selenium in soil creates disease In China, selenium deficient regions are known as the Chinese "disease belt". Here, the daily average intake of selenium is less than 10 micrograms. This contrasts with parts of the US and Canada where daily selenium intake is 170 micrograms. Viral diseases such as Coxsackie's B3, hepatitis B and C, and HIV/AIDS are all on the increase. Coxsackie B3 is further complicated by a heart condition known as "keshans", which is endemic in "disease belt" areas. Since the introduction of selenium-enriched fertilizers onto soils and SCIENCE IN SOCIETY 23, AUTUMN 2004
43 Circle dancing by Sam Burcher crops and into feedstocks and table salt, there has been a decline in keshans. A three year study of an entire town in Jiangsu Province where 20 847 residents were given table salt fortified with selenium showed that hepatitis infection decreased to 4.52 per 1 000 compared to 10.48 per 1 000 in communities using regular table salt. The same researchers concluded that a 200- microgram daily dose of seleniumyeast supplement significantly reduced primary liver cancer associated with hepatitis B and C. It appears that death rates from viruses such as hepatitis, Coxsackie B3 and associated heart diseases like keshans can be greatly reduced by increasing dietary selenium intake and would be similarly effective in slowing the progress of AIDS deaths. The selenium CD4 T cell 'tailspin' Prof Harold Foster of the University of Victoria in Canada has named the link between the viral diseases of HIV/AIDS, Coxsackie's and hepatitis B and C, "The selenium CD4 T cell tailspin", as a way of describing the relationship between selenium and the human immune system. Adults and children with advanced AIDS syndrome display both highly depleted selenium plasma stores and reduced CD4 cell counts. Foster argues that the fall of selenium levels triggers the reduction in CD4 cells, which in turn causes further decline in serum selenium. Retroviruses like HIV depress selenium levels in their hosts by encoding the gene for the human selonenzyme glutathione peroxidase. This allows the virus to replicate indefinitely by continuously depriving the host of glutathione (an inhibitor of reverse transcriptase) and the four basic components of glutathione peroxidase: selenium, cysteine, glutamine and tryptophan. As levels of selenium decline so do CD4 cells which allow "opportunistic" pathogens to invade the immune system and further deplete levels of selenium and CD4 cells in a positive feedback loop whereby if one variable declines, it causes further depression in the other. This downward spiral compromises the ability of the immune system to defend the body from infection, which plays a significant role in AIDS mortality. Foster is currently treating dozens of HIV/AIDS patients in Africa using a protocol of the four nutrients - selenium, cysteine, glutamine and tryptophan. He says that the treatment of HIV/AIDS with nutrition is similar to "curing" type- 1 diabetes with insulin. When high doses of all four nutrients are administered to patients, deficiencies dissolve, Box 1 For a healthy person a daily supplementary intake of 50-200mg of selenium (Se) is safe, but for someone with a compromised immune system an increase of 100% may be necessary to improve selenium plasma levels. Where soil quality is good and produce fresh, the four essential nutrients in preventing and fighting HIV/AIDS and other viral diseases are found in these foods: Selenium - Brazil nuts, garlic mushrooms, liver, round steak, lobster, shrimp, cod, crab, herring, oysters, tuna, barley, whole wheat, egg noodles, Brewers' yeast. Cysteine - Duck, turkey, pork, wheatgerm and yoghurt. Glutamine - Sausage meats, ham, bacon, cottage cheese and ricotta cheese, wheatgerm. Tryptophan - Ham and beef, eggs, almonds, salted anchovies, Parmesan and Swiss cheeses. as do the symptoms associated with AIDS. Patients have been able to return to work within one month of receiving nutritional treatments. Treating primary nutritional deficiencies with selenium and essential amino acids costs approximately $10-$15. (See Box 1) As HIV/AIDS sufferers are often extremely deficient in all four nutrients associated with glutathione peroxidase, the "selenium CD4 T cell tailspin" hypothesis which describes HIV/AIDS as a disease of nutrient deficiency caused by a virus may explain how HIV progresses to AIDS. The American AIDS expert Dr Roberto Giraldo said at a recent seminar in South Africa that AIDS can presently be conquered and curtailed although not totally cured through the adequate ingestion of appropriate micro-nutrients in sufficiently large doses, such as vitamins, amino acids and minerals. The cause of progression of HIV to AIDS is still unknown, but the role of nutrition and supplementation in the prevention and treatment of the disease cannot be ignored. Prof Luc Montagnier (the co-discoverer of HIV) states that AIDS is characterised by a persistent oxidative imbalance and a decrease of glutathione. Changes in biochemical markers cause systemic oxidative stress and damage and Montagnier believes that antioxidants are useful in inhibiting viral replication and associated apoptosis in HIV/AIDS patients. The role of N-acetyl cysteine (NAC) in boosting immunity Glutathione (GSH) is the ubiquitous tripeptide essential for the function of all cells. Studies show that low GSH levels increase HIV replication and impair T cell function that can lead to a progression of HIV disease. And oral administration of the GSH-producing drug N-acetyl cysteine (NAC) improves survival rates in HIV/AIDS patients. NAC helps the body to synthesise glutathione and is beneficial in protecting lung tissue through its antioxidant activity as well as supporting nerve cells, and is effective in treating liver failure where drug toxicity is indicated. NAC also counteracts apoptosis (cell death) and helps maintain and replenish the HIV-damaged CD4 T lymphocytes, crucial for dampening the progression of HIV to AIDS. NAC supplement is recommended to HIV/AIDS sufferers who are receiving anti-retroviral treatments as well as those who are not. There is growing evidence that HIV/AIDS patients want alternative and non-toxic immuneboosting treatments, but would prefer them to be prescribed by the doctors or health care professionals. Despite billions of pounds spent on AIDS research, very little funding or research is allocated for the provision of these types of treatment on the National Health Service (NHS). Raising glutathione levels encourages the immune system to go into anti-cancer and anti-viral mode by replacing decreased levels of plasma cysteine, a major source of sulphur. Patients with advanced HIV infection have tryptophan levels at less than 50% of those in age and gender matched controls and boosting levels of tryptophan can enable the body to synthesise serotonin and niacin which protect against dementia. Improving glutamine levels can alleviate depression and improve digestion by increasing intestinal cell proliferation, and intestinal fluid/electrolyte absorption, which can help combat diarrhoea. The cause of selenium depletion in soil Three major factors have contributed to selenium depletion in the soil. Acid rain is caused by large quantities of sulphur and nitrogen that convert into sulphuric and nitric acids in the atmosphere and changes the capacity of soil to bind ele- continued on page 46 www.i-sis.org.uk
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