Selenium is a micronutrient that is found in our bodies in small amounts but plays a supporting role in regulating the body's immune system, fight inflammation, reduce intravascular coagulation, support detoxification and fight viral replication. Selenium works by inhibiting a protein found in the cytoplasm called Nuclear-factor kappa-B (NF-kB). When NF-kB is released from its inhibitor I-kB, it increases both inflammation and viral replication.

With the help of sufficient selenium naturally, cells lock it safely away in the cytoplasm to prevent it from causing these two negative effects that occur when it is released and moves from the cytoplasm into the nucleus. When its inhibiting bond with I-kB – an inhibitor of kB - is dissolved and released, NF-kB greatly increases both inflammation and virus production.

Selenium and enveloped virus: All enveloped viruses require selenium for their replication. When they attack the body and enter the body cells, they decide to steal selenium from host cells for their individual survival and cell division called replication.

Enveloped viruses require selenium to form protective envelopes that act like skins to protect them from the intercellular environment into which they are released. Just like cells, enveloped viruses cannot survive without selenium-containing proteins to protect them. Viruses acquire that selenium by attacking and destroying the antioxidants in cells where cellular selenium is concentrated – stealing it for their use. Selenium is concentrated in the cells and organs that constitute the immune system including CD4 and macrophage cells, and the thymus, spleen, kidneys, and liver. As viral replication increases, selenium is gradually depleted from the immune system and the body. When selenium levels in the body fall, CD4 counts decrease.

Examples of enveloped viruses include HIV 1, HIV 2, SARS-COV-2, Hepatitis B, Hepatitis I influenza A, Ebola-Zaire, polio, Molluscum contagiosum, Cytomegaly virus, Respiratory Syncytial virus, polio, and measles and Tuberculosis. These diseases are regarded as opportunistic infections that attack the body whenever immunity is compromised or dysregulated as in the case of AIDS-defining illnesses and in cancer patients.

Among the patients with mild COVID-19 without pneumonia, selenium deficiencies were present in 44.4%. Selenium deficiency increased from 44.4% deficiency in mild-Covid cases to 100 per cent in those on ventilation and at death. This indicates that the increasingly rapid loss of selenium in COVID-19 may be a major factor in disease progression and death. In SARS-CoV-2 infection, there is an association between infection severity and T-cell and NK cell dysfunction and lymphopenia; therefore, selenium deficiency needs to be considered in severe cases of COVID-19.”

Selenium is found to reduce the rate of reduction of CD4 count by 43.8% in HIV-infected patients before starting antiviral drugs (ARVS).

CD4 white blood cells are considered the generals of the immune system army. They direct and control the many different types of cells that constitute the immune system. When CD4 counts fall to dangerously low levels the immune system turns out of control and then collapses. CD4 cells live for only four days. Millions must be replaced each day. Viral diseases like HIV deplete selenium from the immune system and cause CD4 counts to crush and decrease. Cytokines like interleukin-6 (IL-6) increase.

Damaged cells that have lost their ability to fight back toxins will increase, spilling toxins into the bloodstream. Cellular and tissue damage, plus the resultant toxin spillage, the loss of selenium, and the cytokine storm initiated by increased levels of IL-6, all contribute to multiorgan failure. That includes kidney, liver, lung, and heart failure.

Sources of selenium include animal protein sources like seafood, organ meats, eggs, Brazil nuts, pieces of bread, cereals, poultry, red meat, eggs a banana, and food supplements rich in selenium are the foods highest in selenium.

I recommend that the hypothesis of selenium's effect on the treatment of enveloped viruses be studied and the population be educated on the benefits of micronutrients, especially selenium in cases of HIV, TB, and COVID-19 in very low Cd4 situations.

Dr. Julius Kamwesiga is Medical Director, AIDS Healthcare Foundation (AHF).