Asymptomatic Human Immunodeficiency Virus-1 Infection with High CD4+ T Cell Count Does Not Alter Iron Metabolism or Hepcidin Levels: The Pilot Study

• Published in: Infectious diseases and therapy Vol. 11; no. 1; pp. 265 - 275
• Main Authors: Szymczak, Aleksandra, Zalewska, Malgorzata, Rymer, Weronika, Jankowska, Ewa A.
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.02.2022; Springer Nature B.V
• Subjects: Antiretroviral agents; Antiretroviral drugs; Asymptomatic; Drug therapy; HIV; Human immunodeficiency virus; Immune system; Infectious Diseases; Internal Medicine; Iron; Medicine; Medicine & Public Health; Metabolic disorders; Metabolism; Original Research; Inflammation; Iron; HIV-1 infection; Hepcidin; Antiretroviral therapy
• ISSN: 2193-8229; 2193-6382
• DOI: 10.1007/s40121-021-00560-1

Introduction The purpose of the study was to assess hepcidin levels and iron metabolism in otherwise healthy human immunodeficiency virus-1 (HIV-1)-infected males and the influence of antiretroviral therapy on hepcidin production, as data in this group are scarce. Methods A total of 89 HIV-1-infected males, 42 on effective antiretroviral therapy (ART)—group A, 47 treatment-naïve—group B, and 27 healthy controls—group C, were enrolled. Erythrocytes parameters, iron metabolism parameters, hepcidin, highly sensitive C-reactive protein (hsCRP), interleukin 6 (IL-6), and soluble transferrin receptor (sTfR) levels were assessed. Conditions related to inflammatory activity, systemic metabolic diseases and iron supplementation were exclusion criteria. Convenience sampling was used. Results Median age in HIV-1 group was 33 years, and 27 years in the control group. Median CD4 + T-cell count was 724 cells/μl in group A, and 488 cells/μl in group B ( p  = 0.0000). Nadir CD4 + T-cell count was 397 cells/μl in group A and 475 cells/μl in group B ( p  = 0.0001). Median value of HIV-1 viral load (VL) in group B was 16 900 copies/mL. The hepcidin value was lower in group A than in groups B ( p  = 0.0008) or C ( p  = 0.0004), without differences between groups B and C. The hepcidin value correlated with ferritin in groups A ( r 2  = 0.16; p  = 0.008) and B ( r 2  = 0.39; p  = 0.000), but not in group C ( r 2  = 0.11; p  = 0.09). In group A, the hepcidin value correlated with current CD4 + count ( r  = 0.48, p  = 0.0012), but there was no correlation in group B. There were no correlations of hepcidin values with CD4 + T cell nadir in group A ( p  = 0.371) or in group B ( p  = 0.477); ART period ( p  = 0.614); VL in group B ( p  = 0.71). No abnormalities of iron metabolism, hsCRP, IL-6, or sTfR were noted. Conclusions Asymptomatic HIV-1 infection does not cause clinically important iron metabolism alterations or increased hepcidin production. Hepcidin values decrease on effective antiretroviral therapy.