Iron Overload in HIV: Clinical Challenges and Management Approaches

Abstract

Iron overload in HIV-infected individuals represents a critical but often under-recognized challenge that impacts disease progression and patient management. The interplay between iron metabolism and HIV infection is complex, with excess iron exacerbating oxidative stress, enhancing viral replication, and contributing to immune dysfunction. This review explores the clinical implications of iron overload in HIV-infected patients, detailing how iron dysregulation can influence disease outcomes and complicate treatment strategies. Key challenges in managing iron overload include accurate diagnosis, balancing therapeutic interventions, and addressing co-infections. Diagnostic difficulties arise from distinguishing iron overload from other forms of anemia, while treatment must navigate the dual issues of managing excess iron and optimizing antiretroviral therapy (ART). Additionally, co-infections such as hepatitis further complicate the management of iron overload and its associated liver damage. Current management strategies involve regular monitoring of iron levels, utilizing phlebotomy or iron chelation therapy, and optimizing ART regimens to mitigate their impact on iron metabolism. Dietary modifications and lifestyle changes also play a role in managing iron levels. Keywords: Iron overload, HIV infection, iron metabolism, oxidative stress, viral replication, antiretroviral therapy, anemia, iron chelation, liver disease, patient management