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Ferritin levels during structured treatment interruption of highly active antiretroviral therapy

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Title: Ferritin levels during structured treatment interruption of highly active antiretroviral therapy
Authors: Bernard Hirschel, Stephen J. Kerr, J Boom, Q. de Mast, S Ulbolyam, Jintanat Ananworanich, Thidarat Jupimai, E Kösters, Pope Kosalaraksa, Kiat Ruxrungtham, Chris Duncombe
Source: HIV Medicine, Vol. 8, No 6 (2007) pp. 388-395
Publisher Information: Wiley, 2007.
Publication Year: 2007
Subject Terms: Adult, Male, 0301 basic medicine, Anti-HIV Agents/ therapeutic use, Anti-HIV Agents, HIV Infections, Reverse Transcriptase Inhibitors/ blood/immunology, 03 medical and health sciences, 0302 clinical medicine, HIV Reverse Transcriptase/ blood/immunology, Antiretroviral Therapy, Highly Active, Humans, Retrospective Studies, ddc:616, HIV Infections/blood/ drug therapy/immunology, Viral Load, Ferritins/ metabolism, HIV Reverse Transcriptase, Antiretroviral Therapy, Highly Active/methods, CD4 Lymphocyte Count, 3. Good health, Treatment Outcome, Ferritins, Multivariate Analysis, Reverse Transcriptase Inhibitors, Female
Description: ObjectiveThe aim of the study was to investigate the influence of highly active antiretroviral therapy (HAART) on iron status and, conversely, the influence of iron status on the response to HAART.MethodsFerritin levels were retrospectively determined in stored plasma from 138 HAART‐naïve, moderately immunosuppressed HIV‐infected Thai patients participating in a structured treatment interruption trial. Ferritin levels were determined at three predefined time‐points: (1) HAART initiation; (2) HAART discontinuation; and (3) HAART resumption.ResultsAt baseline, 31% and 16% of the HIV‐infected patients included in the study had high (>200 ng/mL) and low (P=0.0005) but remained elevated in 62% of the patients with high baseline levels. A low baseline ferritin level was associated with a shorter time (P=0.041) to reach the CD4 cell target for HAART interruption (350 cells/μL), compared with a normal or high baseline ferritin level. Moreover, in a multivariate model, the relative risk (RR) of arriving at this CD4 cell target was significantly higher [RR 1.81; 95% confidence interval (CI) 1.05–3.14] in patients with low baseline ferritin. It is unlikely that inflammation affected ferritin in our patients, as mean levels of C‐reactive protein were not elevated in patients with either high or low ferritin levels.ConclusionsBoth high and low ferritin levels were highly prevalent in moderately immunosuppressed HIV‐positive Thai patients. Structured treatment interruption of HAART resulted in a significant decrease in overall ferritin levels. Furthermore, subjects with low baseline ferritin levels had a faster and greater CD4 response to HAART, suggesting a potential beneficial effect of iron deficiency on immunological recovery after initiation of HAART.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 1468-1293
1464-2662
DOI: 10.1111/j.1468-1293.2007.00481.x
DOI: 10.1111/j.1464-2662.2007.00481.x
Access URL: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1468-1293.2007.00481.x
https://pubmed.ncbi.nlm.nih.gov/17661847
https://archive-ouverte.unige.ch/unige:7115
http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1293.2007.00481.x/full
http://www.ncbi.nlm.nih.gov/pubmed/17661847
https://pubmed.ncbi.nlm.nih.gov/17661847/
https://core.ac.uk/display/60951240
https://archive-ouverte.unige.ch/unige:7115
https://doi.org/10.1111/j.1464-2662.2007.00481.x
https://archive-ouverte.unige.ch/unige:7115
Rights: Wiley Online Library User Agreement
Accession Number: edsair.doi.dedup.....45eec7355e8cbd177d876bcd05e47e62
Database: OpenAIRE
Description
Abstract:ObjectiveThe aim of the study was to investigate the influence of highly active antiretroviral therapy (HAART) on iron status and, conversely, the influence of iron status on the response to HAART.MethodsFerritin levels were retrospectively determined in stored plasma from 138 HAART‐naïve, moderately immunosuppressed HIV‐infected Thai patients participating in a structured treatment interruption trial. Ferritin levels were determined at three predefined time‐points: (1) HAART initiation; (2) HAART discontinuation; and (3) HAART resumption.ResultsAt baseline, 31% and 16% of the HIV‐infected patients included in the study had high (>200 ng/mL) and low (P=0.0005) but remained elevated in 62% of the patients with high baseline levels. A low baseline ferritin level was associated with a shorter time (P=0.041) to reach the CD4 cell target for HAART interruption (350 cells/μL), compared with a normal or high baseline ferritin level. Moreover, in a multivariate model, the relative risk (RR) of arriving at this CD4 cell target was significantly higher [RR 1.81; 95% confidence interval (CI) 1.05–3.14] in patients with low baseline ferritin. It is unlikely that inflammation affected ferritin in our patients, as mean levels of C‐reactive protein were not elevated in patients with either high or low ferritin levels.ConclusionsBoth high and low ferritin levels were highly prevalent in moderately immunosuppressed HIV‐positive Thai patients. Structured treatment interruption of HAART resulted in a significant decrease in overall ferritin levels. Furthermore, subjects with low baseline ferritin levels had a faster and greater CD4 response to HAART, suggesting a potential beneficial effect of iron deficiency on immunological recovery after initiation of HAART.
ISSN:14681293
14642662
DOI:10.1111/j.1468-1293.2007.00481.x