Serum Selenium in Persons Infected with Tuberculosis and HIV In Osogbo, Nigeria

Background: Pulmonary tuberculosis (PTB) and Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) are the major burden of infectious diseases in underdeveloped and developing countries. TB/HIV and TB pose significant global public health challenges, contributing substantially to morbidity and mortality worldwide. In 2022, there were 10.6 million newly diagnosed and officially notified TB cases globally, with 0.67 million individuals co-infected with HIV. Progressive suppression of the immune system in people living with HIV/AIDS (PLHIV) is the main predictor of PTB-HIV co-infection; however, some other factors are being recognized. We therefore aimed to determine the relationship be-tween serum selenium in the context of HIV infection and predictors of PTB-HIV co-infection among adult Nigerians at-tending our HIV clinic. Methods: In this study, 140 HIV-positive patients who satisfied the inclusion criteria were included. We compared anthropometric, clinical, and laboratory data for the 140 subjects with and without PTB. Results from univariate analyses informed the selection of variables to conduct multivariate analysis to determine the predictors of PTB-HIV co-infection. Results: The prevalence of PTB-HIV co-infection in the evaluated cohort was 20.71%. Mean ages of HIV patients with and without PTB were not significantly different: 34.76 ±6.79 vs 35.17± 9.43 years (p=0.847), while the majority of the patients were females [14 (48.3%) vs 82 (73.9%), p=0.008]. The mean ± SD of serum selenium (0.32 ± 0.31 vs 0.65 ± 0.43μmol/L, p=0.002), CD4 count (137.72 ±110.95 vs 324.30 ±229.29 cells/mm3, p<0.001), and body mass index (19.96 ± 3.31 vs 22.03±3.43, p=0.005) were significantly low among patients with HIV-PTB co-infection compared with those with HIV infection only. Chronic cough 55.2% (p< 0.001), weight loss 69.0% (p< 0.001), skin rash 44.8% (p=0.004), pallor 48.3% (p=0.004), xerosis 34.5% (p= 0.003), fluffy hair 31.0% (p=0.002), blue nail 27.6% (p=0.008), and oral candidiasis 41.4 % (p=0.001) were also significantly associated with HIV-PTB co infection. In multivariate analysis, low serum selenium 5.7 times (95% CI: 1.3–25.7, p=0.021), chronic cough was 5.1 times (95% CI: 1.8-14.1, p=0.002), and CD4 count 1.0 (95% CI: 1.0 – 1.01, p=0.018) predict HIV-PTB co-infection. Conclusion: Chronic cough, low serum selenium, and low CD4 cell count predict PTB co-infection among Nigerians with HIV infection. While routine screening for PTB infection in the course of standard care is still essential, rational selenium supplementation and management strategies to prevent low CD4± cell count values may reduce HIV-related immune depletion and morbidity, respectively.