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Objective:To examine the relation between selenium status and child mortality and morbidity among children born to HIV-infected mothers.Design:Prospective cohort study.Methods:Study participants were originally part of a trial to study the effect of maternal vitamin supplements on maternal and child health outcomes. Morbidity information was collected during monthly clinic visits until the child reached 24 months of age. Out of 984 livebirths, 806 had morbidity information, and 610 also had data on plasma selenium levels available.Setting:A study clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania, a tertiary-care hospital.Results:The median age at baseline was 10.5 weeks. A total of 117 (19%) of the 610 study children died during follow-up. In a multivariate model, child plasma selenium levels were inversely associated with risk of all-cause mortality (P-value, test for trend=0.05). Plasma selenium levels were not significantly associated with risk of diarrhea or respiratory outcomes.Conclusions:Among infants born to HIV-infected women in sub-Saharan Africa, selenium status may be important to prevent child mortality. These preliminary findings warrant future reexamination.Sponsorship:This study was supported by the National Institute of Health and Human Development (NICHD R01 32257), and the Fogarty International Center (NIH D43 TW00004).European Journal of Clinical Nutrition (2005) 59, 1250–1258. doi:10.1038/sj.ejcn.1602236; published online 13 July 2005 [ABSTRACT FROM AUTHOR]