NO ICING ON THE ARV CAKE? ….part 2

Medicine has come a long way from the days of AZT – only the second specific antiviral drug ever approved. Almost every year pharmaceutical companies make step-by-step progress improving AIDS therapies. Today ARV drugs are more effective with fewer side effects and easier to take than ever. The most exciting leap forward came in 1996 at the International AIDS Conference in Vancouver, Canada when protease inhibitors were announced. The protease inhibitor class of drugs stopped the mass dying. The veil of desperation, tears, and premature death of the early AIDS Crisis finally lifted. The crying could stop - at least in America, Europe and the advanced industrialized countries that could afford the expensive new drugs. As usual, Africa had to wait. It waited nearly twenty years for AZT and more than a decade for protease inhibitors to arrive. A few in Africa are still waiting.

The pharmaceutical industry built its layer cake of antiretroviral drugs – ARVs – one layer at a time. The first layer was reverse transcriptase inhibitors (RTIs) - then improved RTIs. The second cake layer was protease inhibitors (PIs) - then improved PIs. The third layer includesintegrase inhibitors and fusion inhibitors. The most profitable industry in the world, built a therapeutic cake for HIV that was highly effective, generally affordable, available to most people and easy to take. As Dr Pangloss in Voltaire’s Candide would have proclaimed, “It is the best of all possible therapeutic cakes.” But the painstakingly assembled antiviral layer cake still lacks icing. Why? The main reason is icing is not profitable enough. The icing could not be patented. What is the icing? Selenium.

Selenium is a mineral found on the periodic chart of basic chemical elements. It is found in every cell of the human body as part of both the cell’s and the body’s detox mechanisms. An essential trace element required for health; biologists refer to selenium as the “universally protective element”. That is why not only every cell in the human body requires selenium, but most viruses that make people sick also need it. Where do viruses get it from? They get it from you. Frankly, viruses are selenium thieves.

As the universally protective element, selenium is concentrated in the cells and organs of the immune system. That is because the immune system requires a larger amount to do its job cleansing the body of infectious microbes. When viruses infect the body and redirect selenium towards their own replication, they drain a person’s selenium reserves. That is how viruses, bacteria – and cancer – subvert the ability of the immune system to mount an effective immune response. Falling selenium levels in the body affect the thymus gland and how many CD4 cells it produces. As selenium levels fall, the body’s CD4 count declines in tandem. To reverse this CD4 decline one can increase selenium intake with supplements. One cannot achieve this quickly through diet alone.

While taking ARVs will gradually increase one’s CD4 count if they are HIV positive, adding selenium supplements speeds this up dramatically. In treating HIV ARVs and selenium do two different things. ARVs suppress viral replication quickly, strongly, and usually completely. That allows CD4 count to gradually recover. Working quite differently, selenium supplements act directly on the thymus gland where CD4 and CD8 immune cells are produced. When one increases selenium in the body, that nudges an immunological switch that causes the thymus to produce more CD4 cells and fewer CD8 cells. When selenium falls, the opposite happens. That is probably the most accurate explanation of how HIV causes AIDS - by depleting the body of