[Iron metabolism in patient infected by human immunodeficiency virus type 1].

BACKGROUND: The aim of this work was to assess the major iron metabolism values in patients infected by human immunodeficiency virus (HIV), and to evaluate the correlation between these data and the immunological status of the patients as expressed by CD4 lymphocyte count.

PATIENTS AND METHODS: Seventy-one patients infected by HIV (51 men and 20 women) with mean age of 29 years, plus a control group of 32 healthy subjects were studied. Haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, ferritin, transferrin, serum iron, total iron binding capacity and transferrin saturation index were studied in all of them. Erythrocyte sedimentation rate (ESR) and ALT were also determined in order to estimate the ferritin/ALT quotient.

RESULTS: Mean haemoglobin concentration in the HIV-infected patients (133 +/- 22 g/L) was significantly lower (p < 0.05) than that of the control group (147 +/- 16 g/L), its decrease correlating in accordance with the CD4-cell count. Serum iron values in HIV infected patients (82 +/- 40 micrograms/L) are significantly lower (p < 0.02) than those of the control subjects (115 +/- 56 micrograms/ dL), decreasing in parallel with the number of CD4 lymphocytes. Serum ferritin of the HIV patients (259 +/- 250 ng/mL) is significantly higher that that of the normal group (95 +/- 73 ng/ mL), increasing with the decrease of CD4 cells. Significant correlation was found between ferritin and CD4 cells (r = 0.46, p < 0.0003) and positive correlation between ferritin and ESR (r = 0.70, p < 0.001) were found.

CONCLUSIONS: As HIV infection advances, progressive anaemia is established. The study of iron metabolism in these patients shows a pattern similar to that of the anaemia of chronic diseases, with even higher serum ferritin. These changes might be due to iron sequestration in phagocytic cells induced by release of cytokines.