| ironjustice@aol.com 2006-06-04, 9:21 am |
| The association of serum ferritin and transferrin receptor
concentrations with mortality in women with human immunodeficiency
virus infection.
Gordeuk VR, Onojobi G, Schneider MF, Dawkins FW, Delapenha R, Voloshin
Y, von Wyl V, Bacon M, Minkoff H, Levine A, Cohen M, Greenblatt RM
Haematologica. 2006 May 16;
BACKGROUND AND OBJECTIVES: Whether degree of iron stores influences
progression of human immunodeficiency virus (HIV) disease is
controversial. We studied the relationship of indirect measures of iron
stores with mortality in highly active antiretroviral therapy
(HAART)-na=EFve participants from the Women's Interagency HIV Study.
DESIGN AND METHODS: One hundred and fifty-eight HIV-infected women who
died before July 1996 were individually matched by CD4+ cell count
(within +/- 50 cells/microL) and HIV RNA level (within +/- 0.50 log10
copies/mL) to 154 controls. Serum ferritin and transferrin receptor
concentrations were measured in 151 pairs of women. RESULTS: Using
multivariable conditional logistic regression models that were adjusted
for self-reported antiretroviral therapy use, age, smoking status,
ethnicity, hemoglobin concentration, C-reactive protein and aspartate
amino transferase, a log10 increase in baseline serum ferritin
concentration was associated with a 1.67-fold increase in the odds of
death (95% CI: 0.98, 2.86) and a one-unit decrease in transferrin
receptor to log10 ferritin ratio was associated with a 1.12-fold (95%
CI: 1.01, 1.23) increase in the odds of death. INTERPRETATION AND
CONCLUSIONS: In this study, higher indirect measures of iron status
were associated with reduced survival among HAART-na=EFve HIV-infected
women. Additional prospective studies with data on direct measures of
iron status along with randomized trials are needed to elucidate the
current equipoise over whether iron supplementation is beneficial by
preventing anemia or harmful by increasing iron stores in HIV-infected
women.
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