title: Assessment of iron status using plasma transferrin receptor in pregnant women with and without human immunodeficiency virus infection in Malawi.
abstract: BACKGROUND
  Although anemia is highly prevalent during pregnancy and is common during human immunodeficiency virus (HIV) infection, anemia and iron status have not been well characterized in HIV-infected pregnant women.
  
  
  OBJECTIVE
  To gain insight into iron status in HIV-infected pregnant women using plasma transferrin receptor and related indicators of anemia.
  
  
  METHODS
  Plasma transferrin receptor, ferritin, alpha1-acid glycoprotein, C-reactive protein and hemoglobin concentrations were measured in pregnant women, gestational age 18-28 weeks, seen in an urban antenatal clinic in Blantyre, Malawi.
  
  
  RESULTS
  The prevalence of anemia among 662 HIV-positive and 190 HIV-negative pregnant women was 73.1% and 50.0%, respectively (P<0.0001). Among HIV-positive and HIV-negative women, median plasma transferrin receptor concentrations were 24.4 and 24.1 nmol/l (P=0.5), respectively, and median plasma ferritin concentrations were 17.8 and 20.8 microg/l (P<0.05), respectively. There was a large overlap in plasma transferrin receptor concentrations among women with and without anemia. Using the combination of hemoglobin and ferritin as a standard, the sensitivity and specificity of plasma transferrin receptor in diagnosing iron deficiency anemia was estimated at 45.9% and 68.1%, respectively.
  
  
  CONCLUSIONS
  The use of plasma transferrin receptor concentrations as an indicator of iron deficiency anemia may be limited in pregnant women with chronic inflammation and infection.
authors: Departments of Ophthalmology and Epidemiology, Johns Hopkins University Schools of Medicine and Hygiene and Public Health, Baltimore, Maryland, USA. rdsemba@jhmi.edu
authors: R D
authors: RD
authors: Semba
authors: N
authors: N
authors: Kumwenda
authors: D R
authors: DR
authors: Hoover
authors: T E
authors: TE
authors: Taha
authors: L
authors: L
authors: Mtimavalye
authors: R
authors: R
authors: Broadhead
authors: W
authors: W
authors: Eisinger
authors: P G
authors: PG
authors: Miotti
authors: J D
authors: JD
authors: Chiphangwi
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007501:Iron / Q000097:blood*; D008295:Malawi / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000453:epidemiology; D011251:Pregnancy Complications, Infectious; D015995:Prevalence; D011990:Receptors, Transferrin / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D011990:Receptors, Transferrin; D007501:Iron