Serum ferritin in HIV-positive patients is related to immune deficiency and inflammatory activity

Int J STD AIDS. 2015 May;26(6):393-7. doi: 10.1177/0956462414539669. Epub 2014 Jun 9.

Abstract

To analyse the prevalence of high ferritin levels in asymptomatic HIV patients and its related factors we conducted a cross-sectional study of a cohort of HIV outpatients in regular follow-up. Epidemiological, clinical, analytical and therapeutic data were collected. Patients completed a questionnaire about cardiovascular risk factors and underwent a physical examination and a 12-h fasting blood analysis. High ferritin levels were defined as a plasma ferritin level >200 µg/L in women and >300 µg/L in men. A total of 571 patients (78.1% men) were included. Median age was 43.2 years, HIV sexual transmission 68.5%, median CD4 count 474 cells/µL, 36.3% AIDS cases, 86.2% on antiretroviral therapy and 74.8% of them with undetectable viral load; 14.6% metabolic syndrome criteria, and mean cardiovascular risk at 10 years 6.67%. High ferritin levels prevalence was 11%, and related factors were a CD4 count <350 cells/µL (odds ratio, OR 2.37 [1.3-4.1], p = 0.003), ultrasensitive C-reactive protein >3 mg/L (OR 2.67 [1.5-4.7], p = 0.001) and chronic hepatitis C virus infection (OR 2.77 [1.5-4.9], p = 0.001). High ferritin levels are not uncommon in HIV patients, and they correlate with immunosuppression defined as CD4 count <350 cells/µL, higher ultrasensitive C-reactive protein and hepatitis C virus infection, and in contrast to the general population, they are not related to increased cardiovascular risk or metabolic syndrome.

Keywords: AIDS; HIV; Iron overload; cardiovascular risk; ferritin; immunodeficiency; metabolic syndrome.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • C-Reactive Protein / metabolism
  • CD4 Lymphocyte Count
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Cross-Sectional Studies
  • Female
  • Ferritins / blood*
  • HIV Infections / blood
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV-1 / immunology
  • Humans
  • Immunologic Deficiency Syndromes
  • Inflammation / blood*
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires
  • Viral Load

Substances

  • Anti-HIV Agents
  • C-Reactive Protein
  • Ferritins

Supplementary concepts

  • Immune Deficiency Disease