Search

Objectives: The relationship between Fe status and HIV infection is complex and poorly understood. While anaemia is a major complication of HIV infection, higher Fe stores may be associated with disease progression. There is limited and conflicting data available from Africa. Design: Cross-sectional and prospective cohort study. Setting, subjects and methods: We examined the association between postpartum Fe status (Hb, serum ferritin (SF) and transferrin receptor (TfR)) and viral load (VL) and HIV-related mortality in 643 HIV-positive Zimbabwean women over a period of 12 months. Results: In non-anaemic women a log10 increase in SF was associated with a 2·3-fold increase in VL (P=0·019); this association was absent in anaemic women. In prospective analyses, a log10 increase in SF was associated with a 4-fold increase in mortality by 12 months (P=0η002). Hb was negatively associated with VL (P=0·001) and mortality (P=0·047). The adverse associations between SF and both VL and mortality were found at SF concentrations >45 μg/l (P<0·05). Controlling for α1 acid glycoprotein, a marker of inflammation, attenuated the association between both SF and VL and mortality, but these remained significant. Conclusions: These results are consistent with the hypothesis that high Fe stores have adverse consequences in HIV infection. If adverse consequences are real, our data suggest that they occur at SF concentrations exceeding those consistent with adequate Fe nutriture. [ABSTRACT FROM AUTHOR]

Objectives:The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of α-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population.Subjects:We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women.Results:SF was significantly higher in APR-positive (AGP>1 g/l) women (P<0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P<0.001). However, among anemic women (Hb<110 g/l), APR-positive women had marginally lower TfR concentrations (P=0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women.Conclusions:AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoeisis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators.European Journal of Clinical Nutrition (2009) 63, 787–793; doi:10.1038/ejcn.2008.33; published online 28 May 2008 [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Twenty seven babies with severe non-haemolytic hydrops fetalis were born during a 7 1/4 year period (1/1400 total births). Thirteen were live born and admitted to the intensive care nursery, but only three survived. The survivors differed from those live born infants who died in the neonatal period in that the cause of the hydrops was discovered antenatally, their serum concentrations of total protein and albumin were normal, and they had no structural anomaly. A scheme of investigation of the severely hydropic fetus in the antenatal period is outlined and the role of active obstetric management is evaluated. [ABSTRACT FROM AUTHOR]