Hemoglobin and serum ferritin concentration in anemic and nonanemic human immunodeficiency virus females in India

S. Kharb, M. Lallar, P. Ghalaut, J. Bala, M. Kumawat, S. Nanda
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Abstract

Aim: This study was planned to assess hemoglobin (Hb) and serum ferritin in anemic and nonanemic HIV females. Materials and Methods: The present prospective study was conducted during 2012–2013 in the department of biochemistry in collaboration with department of medicine (HIV clinic). In 200 seropositive females (age: 18–50 years) attending antiretroviral therapy clinic after routine gynecological and hematological investigations, CD4 count, serum iron, and ferritin were analyzed by chemiluminescence. Results were calculated by SPSS version 17. Student's t-test and regression analysis were done. Results: Hb showed a positive correlation with serum iron and ferritin and was statistically significant. Anemia occurs most commonly in these patients and indicates increased risk of mortality. Serum ferritin was correlated to CD4 cell counts indicating that level of HIV disease progression and viral load. Finding of high serum ferritin with high CD4 in the present study support to the role of inflammation in increased serum ferritin levels and high iron stores in HIV may have adverse events and effects. Conclusion: High ferritin levels in HIV patients suggest that redistribution of iron and decreased activity of erythropoietic cells is mainly responsible for anemia. Serum ferritin levels need to be evaluated carefully in HIV patients with advanced disease. Iron overload and adverse HIV related outcomes due to high iron exposure can be prevented by screening the iron status and stores in anemic HIV women. Also there is need of other effective strategies of locating other causes of anemia that should be adopted.
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印度贫血和非贫血人类免疫缺陷病毒女性的血红蛋白和血清铁蛋白浓度
目的:本研究计划评估贫血和非贫血HIV女性的血红蛋白(Hb)和血清铁蛋白。材料与方法:本前瞻性研究于2012-2013年在生物化学系与医学部(HIV门诊)合作进行。对200名接受抗逆转录病毒治疗的女性(年龄:18-50岁)进行常规妇科和血清学检查,用化学发光法分析CD4计数、血清铁和铁蛋白。结果采用SPSS version 17进行计算。进行学生t检验和回归分析。结果:Hb与血清铁、铁蛋白呈正相关,且有统计学意义。贫血在这些患者中最常见,表明死亡风险增加。血清铁蛋白与CD4细胞计数相关,表明HIV疾病进展水平和病毒载量。在本研究中发现高血清铁蛋白与高CD4支持炎症在血清铁蛋白水平升高和HIV高铁储存中的作用可能有不良事件和影响。结论:HIV患者高铁蛋白水平提示铁的再分配和红细胞活性降低是导致贫血的主要原因。需要仔细评估晚期艾滋病患者的血清铁蛋白水平。铁超载和由于高铁暴露导致的艾滋病毒相关不良后果可通过筛查贫血艾滋病毒妇女的铁状态和储存来预防。此外,还需要其他有效的策略来确定贫血的其他原因。
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