Iron metabolism and antiretroviral therapy (ART) in women with HIV in Abidjan (Côte d’Ivoire)

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Research Paper 01/07/2012
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Iron metabolism and antiretroviral therapy (ART) in women with HIV in Abidjan (Côte d’Ivoire)

Soualio Kamagate, Mathieu N. Bléyéré, Mama Kone, Leandre K. Kouakou, Sylvie Doumate, Augustin K. Amonkan, Duni Sawadogo, Etienne E. Ehile, Henri Chenal, Paul A. Yapo
Int. J. Biosci.2( 7), 11-22, July 2012.
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We have initiated the investigations in women of reproductive age with HIV to evaluate and to characterize their iron metabolism. Moreover, to demonstrate the importance of ART, a study was conducted to compare the iron stores and the components of iron status between women of reproductive age with ART and those naive of ART. To do this, 60 women with ART and 60 women naive of ART were recruited in a specialized centre for treatment of HIV (ICBRA) based on the criteria for inclusion and exclusion. The mean age of women was 35.9 ± 0.4 years with extremes of 18 and 45 years. Blood samples were obtained from each subject to search the different biological indicators of iron status assessment. The results of our investigations showed that all the biological parameters searched of iron status evaluation, are degraded in enrolled women. Otherwise, our study revealed that women naive of ART indicated a more altered iron status than those with ART (88.3 % vs 78.3 %). Abnormal iron status consisted of iron deficiency, iron deficiency anaemia, inflammatory anaemia and inflammatory anemia associated with iron deficiency. Among the different components of iron status, inflammatory anaemia indicated high prevalence rates both in women naive of ART and women with ART (70 % vs 65 %). It appears from this study that antiretroviral treatment greatly disturbs iron metabolism in women of reproductive age with HIV infection. In addition, the inflammatory anaemia is significantly associated with ART in women with HIV infection.


Asuncion G, Del Olmo ML, Sastre J, Millan A, Pellin A, Pallardo FV. 1998. AZT treatment induces molecular and ultrastructural oxidative damage to muscle mitochondria. Prevention by antioxidant vitamins. Journal of Clinical Investigation 102, 4–9.

Beisel WR. 1992. History of nutritional immunology: introduction and overview. Journal Nutrition 122, 591–6.

Beuzit  Y,  Bougarel  J,  Ngouonimba  J.  1992. Modifications hématologiques périphériques et médullaires lors de l’infection par le Virus de l’Immunodéficience Humaine (VIH) en Afrique centrale. Medecine Tropicale 40, 193-199.

Boelaert JR, Weinberg GA, Weinberg ED. 1996: Altered iron metabolism in HIV infection: mechanisms, possible consequences, and proposals for management. Infectious agents and disease 5(1), 36-46.

Brock JH. 1994. Iron in infection, immunity, inflammation and neoplasia. In: Iron Metabolism in Health and Disease. Ed. Brock JH, Halliday JW, Pippard MJ, Powell LW.Philadelphia: Saunders, 353– 389.

Bruera D, Luna N, David DO, Bergoglio LM, Zamudio J. 2003. Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy. AIDS 17, 1917–1923.

Chevalier P, Sevilla R, Sejas E, Zalles L, Belmonte G, Parent G. 1998. Immune recovery of malnourished children takes longer than nutritional recovery: implications for treatment and discharge. Journal of Tropical Pediatrics 44(5), 304–7.

Coffie PA, Tonwe-Gold B, Tanon AK, Amani-Bosse C, Bédikou G, Abrams EJ, Dabis F, Ekouevi DK. 2010. Incidence and risk factors of severe adverse events with nevirapine-based antiretroviral therapy in HIV-infected women. MTCT-Plus program, Abidjan, Cote d’Ivoire BMC Infectious Diseases 10, 188.

Danwe C, Atchou G, Nkam M, Mbuagbaw J, Mougnoutou R, Nkouanfack C, Mbanya D, Agbor AG, Lohoue J, Ngogang YJ. 2005. Effect of Antiretroviral Therapy on Lipid Metabolism in HIV/AIDS Subjects in Cameroon. Journal of Medical Sciences 5, 78-82.

Diallo D A, Baby M, Dembele M, Keita A, Sidibe A, Cisse IAH, Diop CT, Maïga II, Traore AK, Traore HA. 2003. Fréquence, facteurs de risque et valeur pronostique de l’anémie associée au au VIH/sida chez l’adulte au Mali. Bulletin de la Société de Pathologie Exotique 96 (2), 123-127.

Drain PK, Kupka R, Mugusi F, Fawzi WW. 2007. Micronutrients in HIV-positive persons receiving highly active antiretroviral therapy. American Journaj of Clinical Nutrition 85, 333– 45.

Fleming A F. 1997. HIV and blood transfusion in sub-Saharan Africa. Transfusion science 18, 167-79.

Gordeuk VR, Delanghe JR, Langlois MR, Boelaert JR. 2001. Iron status and the outcome of HIV infection: an overview. Journal Clinical Virology 20(3), 111-5.

Handelman, GJ, Levin NW. 2008. Iron and anemia in human biology: a review of mechanisms. Heart Failure Reviews 13(4), 393-404.

Ihaka R, Gentleman R. 1996. R : a language for data analysis and graphics. J. computation, graphic and statistic 5, 299-314.

Institute of Medecine (IOM/USA). 1990. Comittte on nutritional status during pregnancy and lactation. Nutrition during pregnancy: weight gain and nutrient supplements. Washington DC. National Academy Press.

Johannessen, A., E. Naman, S.G. Gundersen and J.N. Bruun, 2011. Antiretroviral treatment reverses HIV-associated anemia in rural Tanzania. BMC Infect Dis.

Katodritou, E. and J. Christakis, 2006. Recent advances in the pathogenesis and management of anaemia of chronic disease. Haema 9(1), 45-55.

Kupka R, Msamanga GI, Mugusi F, Petraro P, Hunter DJ, Fawzi WW. 2007. Iron Status Is an Important Cause of Anemia in HIV-Infected Tanzanian Women but Is Not Related to Accelerated HIV Disease Progression Journal of Nutrition 137, 2317–2323.

Massawe, NS. 2002. Anaemia in women of reproductive age in Tanzania. East African Medical Journal 79(9), 461-6.

Mata-Marín JA, Gaytán-Martínez JE, Martínez-Martínez ER, Arroyo-Anduiza CI Fuentes-Allen JL. 2010. Casarrubias-Ramirez M. Risk factors and correlates for anemia in HIV treatment-naïve infected patients: a cross-sectional analytical study BMC Research Notes 3, 230.

McCord JM. 2004. Iron, Free Radicals, and Oxidative Injury. Journal of Nutrition 134, 3171S– 3172S.

McDermid JM, Jaye A, Schim van der Loeff MF, Todd J, Bates C, Austin S, Jeffries D, Awasana AA, Whittlex AA, Prentice A. 2007. Elevated iron status strongly predicts mortality in West African adults with HIV infection. Journal of Acquired Immune Deficiency Syndromes 46, 498-507.

Millogo A, Sawadogo AB, Sawadogo AP, Lankoandé D. 2002. Neuropathies périphériques révélatrices de l’infection par le VIH au Centre hospitalier de Bobo-Dioulasso (Burkina Faso). Bulletin de la Société de Pathologie Exotique 95(1), 27-30.

Mobarak YM. 2011. The in vivo and in vitro Developmental Toxicity and Teratogenicity of the Anti-AIDS Drugs (Human and Experimental Animal Studies). Trends Applied Science Research 6, 208-236.

Moh R, Danel C, Sorho S, Sauvageot D, Anzian A, Minga A, Gomis OB, Konga C, Inwoley A, Gabillard D. 2005. Haematological changes in adults receiving a zidovudine-containing HAART regimen in combination with cotrimoxazole in Cote d’Ivoire. Antiviral Therapy 10, 615-624.

Ministère de la Santé et de l’Hygiène Publique (MSHP). 2009. Rapport Annuel VIH/sida du secteur santé en Cote d’Ivoire 2007-2008.

Nacoulma EWC, Some Y, Tieno H, Diallo I, Zoungrana A, Bougnounou R, Ouédraogo C, Drabo J, Guiard-Schmid JB. 2007. Évolution des paramètres hématologiques au cours du traitement antirétroviral chez les patients infectés par le VIH au Burkina Faso. Bulletin de la Société de Pathologie Exotique 100 (4), 271-274.

Ngondi, J. L., S.H.L. Etame, M. Fonkoua, H. Yangoua and J. Oben, 2007. Lipid Profile of Infected Patients Treated with Highly Active Antiretroviral Therapy in Cameroon. Journal of Medical Sciences 7, 670-673.

Nguemaim NF, Mbuagbaw J, Nkoa T, Teto G, Njitchouang GR, Pouomogne DJ, Same-Ekobo A, Asonganyi T. 2010. Changes in Lipid Profiles in Two Groups of HIV-1 Infected Patients in Cameroon on Two Treatment Regimens with Either Efavirenz or Nevirapine, in Association with Reverse Transcriptase Inhibitors. Journal of Medical Sciences 10, 25-33.

Omoregie R, Omokaro EU, Palmer O, Ogefere HO, Egbeobauwaye A, Adeghe JE, Osakue SI, Ihemeje V. 2009: Prevalence of anaemia among HIVinfected patients in Benin City, Nigeria. Tanzania Journal of Health Research 11, 1-4.

ONUSIDA, 2009. Directives pour l’élaboration d’indicateurs de base.

Patwardhan MS, Golwilkar AS, Abhyankar JR, Atre MC. 2002. Haematological Profile of HIV positive patients. Indian Journal of Pathology and Microbiology 45, 147-50.

Potdar PD, Daswani BS, Rane NJ. 2011. Drug Resistance Mutations to Protease and Reverse Transcriptase Inhibitors in Treatment Naive HIV-1 Clade C Infected Individuals from Mumbai, International Journal Virology 7, 13-23.

Russell EC, Charalambous S, Pemba L, Churchyard GJ, Grant AD, Fielding K. 2010. Low haemoglobin predicts early mortality among adults starting antiretroviral therapy in an HIV care programme in South Africa: a cohort study. BMC Public Health 10,433.

Semba RD, Shah N, Strathdee SA, Vlahov D. 2002. High prevalence of iron deficiency and anemia among female injection drug users with and without HIV infection. Journal of Acquired Immune Deficiency Syndromes 29, 142–144.

Société de Nutrition et de Diététique de Langue Française (SNDLF). 2001. Anémies nutritionnelles Cahier de Nutrition et de Diététique 36, 76-81.

Statsoft. 2005. Statistica (Data Analysis Software System). Version 7.1 available at www. (accessed 2 february 2006).

Totin D, Ndugwa C, Mmiro F, Perry RT, Jackson JB, Semba RD. 2002. Iron Deficiency Anemia Is Highly Prevalent among Human Immunodeficiency Virus–Infected and Uninfected Infants in Uganda Journal of Nutrition 132, 423–429.

Trumbo P, Yates AA, Schlicker S, Poos M. 2001. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Journal American Dietetic Association 101, 294–301.

UNICEF/UNU/WHO. 2001. Iron deficiency anemia: assessment, prevention, and control. WHO/NHD/01.3 Geneva, Switzerland: WHO. A guide for programme managers.

Vernet M, Corberand J, David V, Deugnier Y, Frey J, Giraudet P, J-C. Renversez and G. Sebahoun, 2001. Algorithmes de prescription recommandés pour le diagnostic d’un déficit et d’une surcharge en fer. Annales de Biologie Clinique (Paris) 59, 149-55.

Weiss G, Goodnough LT. 2005. Anemia of chronic disease. New England Journal of Medecine 352(10), 1011-23.

Wisaksana R, Sumantri R, Indrati AR, Zwitser A, Jusuf H, Mast QD, Crevel RV, Ven AVD. 2011. Anemia and iron homeostasis in a cohort of HIVinfected patients in Indonesia. BMC Infectious Diseases 11, 213.