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Assessment of iron status using plasma transferrin receptor in pregnant women with and without human immunodeficiency virus infection in Malawi

European Journal of Clinical Nutrition volume 54, pages 872–877 (2000)Cite this article

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.

Study design: Plasma transferrin receptor, ferritin, α1-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 µg/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.

Conclusion: 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.

Sponsorship: The National Institutes of Health (HD32247, HD30042, HIVNET contract N01-AI-35173-117), the Fogarty International Center, and the United States Agency for International Development (Cooperative Agreement HRN-A-00-97-00015-00).

European Journal of Clinical Nutrition (2000) 54, 872–877

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Authors and Affiliations

  1. Departments of Ophthalmology and Epidemiology, Johns Hopkins University Schools of Medicine and Hygiene and Public Health, Baltimore, Maryland, USA

    RD Semba, N Kumwenda, TE Taha & W Eisinger

  2. Department of Statistics, Rutgers University, Piscattaway, New Jersey, USA

    DR Hoover

  3. Departments of Obstetrics and Gynaecology and Paediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi

    L Mtimavalye, R Broadhead & JD Chiphangwi

  4. National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA

    PG Miotti

Authors
  1. RD Semba
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  2. N Kumwenda
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  3. DR Hoover
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  4. TE Taha
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  5. L Mtimavalye
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  6. R Broadhead
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  7. W Eisinger
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  8. PG Miotti
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  9. JD Chiphangwi
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Contributions

Guarantor: RD Semba.

Contributors: RD Semba, PG Miotti and JD Chiphangwi were responsible for the concept and planning of the study. Field work was supervised by N Kumwenda and TE Taha, and clinical work was carried out by L Mtimavalye and R Broadhead. D Hoover provided statistical expertise, and W Eisinger conducted laboratory analyses. All co-authors contributed to the writing of the paper.

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Correspondence to RD Semba.

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Semba, R., Kumwenda, N., Hoover, D. et al. Assessment of iron status using plasma transferrin receptor in pregnant women with and without human immunodeficiency virus infection in Malawi. Eur J Clin Nutr 54, 872–877 (2000). https://doi.org/10.1038/sj.ejcn.1601106

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601106

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