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Title: Iron overload, an immunosuppression marker in HIV-infected patients.
Authors: López-Calderón, C
Palacios, R
Cobo, A
Moreno, T
Ruiz, J
Nuño, E
Márquez, M
Santos, J
metadata.dc.contributor.authoraffiliation: Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Keywords: Infecciones por VIH;Sobrecarga de Hierro;Síndrome X Metabólico;Inmunosupresión;Seropositividad para VIH;VIH;Quimioterapia;Análisis Químico de la Sangre;Enfermedades Bacterianas de Transmisión Sexual
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Immune System Diseases::Immunologic Deficiency Syndromes::HIV Infections
Medical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Iron Metabolism Disorders::Iron Overload
Medical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Metabolic Syndrome X
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunosuppression
Medical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Retroviridae Infections::Lentivirus Infections::HIV Infections::HIV Seropositivity
Medical Subject Headings::Organisms::Viruses::RNA Viruses::Retroviridae::Lentivirus::Lentiviruses, Primate::HIV
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Clinical Chemistry Tests::Blood Chemical Analysis
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Sexually Transmitted Diseases, Bacterial
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies
Issue Date: 11-Nov-2012
Publisher: BioMed Central
Citation: López-Calderón C., Palacios R., Cobo A., Moreno T., Ruiz J., Nuño E. et al. Iron overload, an immunosuppression marker in HIV-infected patients. Journal of the International AIDS Society. 2012;15(Suppl. 4):18304
Abstract: Purpose: Iron overload (IO) has been associated with increased cardiovascular risk (CVR) and metabolic syndrome (MS) in the general population; both elevated CVR and MS are frequent in HIV- patients. Our aim was to analyze the prevalence of IO in a cohort of asymptomatic patients with HIV infection, and related factors. Methods: Cross-sectional study of a cohort of HIV outpatients in regular follow-up. Demographic, epidemiological, clinical, analytical and therapeutic data were collected. Patients completed a questionnaire about CVR factors and 10-year CV disease risk estimation (Framingham score), underwent a physical exam, and a fasting blood analysis. IO was defined as a plasma ferritin level higher than 200 m/L in women and 300 m/L in men. Results: 571 patients (446 men, 125 women), with a mean age of 43.2 years, sexual transmission of HIV in 68.5%, median CD4 count 474 cell/μL (IQR: 308-666), and 36.3% Aids cases 86.2% were on antiretroviral therapy (ART), and 74.8% of them had undetectable HIV viral load 14.6% met MS criteria, and mean CVR at 10 years was 6.67%. IO was detected in 11% of cases. Patients with IO were more immunosuppressed (CD4 count 369 vs 483/μL, p<0.0001), presented a higher prevalence of detectable HIV viral load (17.6% vs 8.9%; p<0.005), and of Aids cases (14.9% vs 8.7%; p<0.023), and lower plasma levels of cholesterol, HDLc and LDLc (154 vs 183, 34 vs 43, 93 vs 110 mg/dL, respectively; p<0.0001. In the multivariate analysis, the only related factor was CD4 count <350 cell/μL (OR 2.86, 95% CI 1.6-4.9; p<0.0001). IO was not associated with CVR nor with MS. Conclusions: IO is not uncommon in HIV patients, and it is only related with immunosuppression defined as CD4 count <350 cell/ mL, and in contrast to general population, it is not related with increased CVR nor with MS.
metadata.dc.identifier.doi: 10.7448/IAS.15.6.18304
ISSN: 1758-2652 (Online)
Appears in Collections:01- Artículos - Hospital Virgen de la Victoria

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