Assessment of iron status using plasma transferrin receptor in pregnant women with and without human immunodeficiency virus infection in Malawi.
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.
Semba
R D
RD
Departments of Ophthalmology and Epidemiology, Johns Hopkins University Schools of Medicine and Hygiene and Public Health, Baltimore, Maryland, USA. rdsemba@jhmi.edu
Kumwenda
N
N
Hoover
D R
DR
Taha
T E
TE
Mtimavalye
L
L
Broadhead
R
R
Eisinger
W
W
Miotti
P G
PG
Chiphangwi
J D
JD
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
D011990:Receptors, Transferrin; D007501:Iron