BACKGROUND: HIV/AIDS remains a big threat to human survival in sub- Sahara Afirca. Nigeria has the second largest epidemics next to South Africa, globally. Skin disorders in HIV/AIDS contribute significantly to morbidity and mortality and correlate significantly with immunossuppression. Meanwhile, selenium in the recent time has been recognized as an essential micronutrient and its deficiency has been shown to impair the antioxidant defence system with consequent host oxidative injury in HIV medicine. Selenium as related to HIV has not been sufficiently studied in Nigeria and there has been no published work on selenium in relation to cutaneous manifestations. AIM AND OBJECTIVES: The aim of this study is to determine the serum levels of selenium in adults with HIV/AIDS and controls and its relationship to the CD4+cell count, cutaneous manifestations of HIV/AIDS, and WHO staging of HIV. The study also set out to assess the impacts of HAART on serum selenium and CD4 count at LAUTECH Teaching Hospital Osogbo, Nigeria. METHODOLOGY: A total of 280 subjects; 140 HIV/AIDS patients and 140 controls were recruited from HIV clinic and from among staffs and students of LAUTECH Teaching Hospital, Osogbo respectively. They were examined for cutaneous manifestations and samples were taken for CD4 count and serum selenium. RESULTS: The mean age was 35.04 + 8.83 years for the HIV/AIDS patients and 32.21 + 8.30 years for the controls. The mean serum selenium for HIV/AIDS patients was significantly lower at 0.55+ 0.45µmol/L compared to 0.92+ 0.57µmol/L found among relatively healthy adult control group (p < 0.05). The prevalence of cutaneous manifestations of HIV/AIDS patients was significantly higher for patients (77.9%) compared to controls (22.1%). The prevalent six cutaneous disorders include: PPE, 27 (19.3%), xeroderma 23 (16.40%), dermatophytosis 22 (15.71%), fluffy hair 19 (13.57%), blue-black nail pigmentation 18 (12.86), and Pityriasis vesicolor 15(10.71). The study established an inverse relationship between CD4 count and cutaneous disorders. Skin disease was 2.2 times commoner among patients with CD4 count < 200cell/mm3 than patients with CD4 count > 500 cell/mm3 . Selenium levels significantly reduce as HIV disease progresses as indicated by both combined WHO clinical and laboratory staging of HIV (F=5.589, p = 0.001). However intra-stage post-hoc analysis showed CD4 count is a superior differentiating marker of disease progression down the WHO stages than serum selenium. Selenium correlate significantly with CD4 count (r = 0.223, p < 0.001). There was significant increase in BMI, CD4 count, and serum selenium. (p < 0.05) after six months of HAART. Viral load assessment was not done due to financial constraint. CONCLUSION: The CD4 count and serum selenium correlate with progression of HIV infection. Selenium became repleted into human serum following 6 months of HAART. However, analysis confirmed superiority of CD4 counts to serum selenium in the step by step progression of disease down the WHO combined clinical and laboratory staging. Cutaneous manifestions like PPE, xeroderma, integuement disorders like; blue-black nail pigmentation,and fluffy hair reflect profound immunosuppression as a correlate of both CD4 count and serum selenium