Iron Metabolism Markers in Patients with Tuberculosis Combined with HIV Infection

Abstract

Background. Changes of iron metabolism in patients with tuberculosis combined with HIV infection is an important task of phthisiology, since, on the one hand, iron deficiency can have a negative effect on the course of the tuberculous process. On the other hand, compensation for iron deficiency may be creating an iron overload situation, promoting replication of M. tuberculosis. Aims to study in a comparative aspect, changes in iron metabolism markers in patients with tuberculosis combined with HIV infection and without it. Methods. The study included 284 tuberculosis patients who were divided into 2 groups. The first group included 141 patients with tuberculosis combined with HIV (TB/HIV group). The comparison group consisted of 143 tuberculosis patients without HIV (TB group). The assessment of the bodys iron supply was carried out in terms of the concentration of serum iron, transferrin (TF), and ferritin (FT). The study was conducted separately in men and women, since the indicators of iron metabolism in healthy men and women differ significantly. Results. It was found that in men with TB/HIV patients, the decrease in serum iron less than the lower limit of the norm took place in 47.6%, and in the TB group in 27.3% of cases (p 0.01). The concentration of TF in the blood serum in the group of TB/HIV patients in men decreased in 69.9%, and in the group of TB patients in 31.2% of cases (p 0.01). The level of FT in the TB/HIV group increased in 19.4%, and in the TB group in 8.3% of cases (p 0.05). In women, a decrease in iron levels in the group of TB/HIV patients was observed in 39.5%, and in the TB group only in 2.2% of cases (p 0.01), a decrease in the level of TF was observed in 55.2% and 24.3% (p 0.01). A decrease in ferritin levels below 15 ng/ml was observed in 15.7% of women with TB/HIV and in 10.6% of TB patients. A negative relationship was found between iron content and CRP levels. Conclusion. The results of studied made it possible to conclude that in all cases the decrease in iron was caused not by a true deficiency of iron, but by its redistribution in the body. At the same time, a small number of women with tuberculosis combined with HIV infection and tuberculosis without HIV infection showed a significant decrease in ferritin levels, which indicated that they had a true iron deficiency.