Underdiagnosis of iron deficiency anaemia in HIV-infected individuals : a pilot study using soluble transferrin receptors and intensive bone marrow iron stores to improve the diagnosis

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dc.contributor.author Mankgele, Mahlatse
dc.contributor.author Variava, Ebrahim
dc.contributor.author Moloantoa, Tumelo
dc.contributor.author Otwombe, Kennedy
dc.contributor.author Hlongwane, Khuthadzo
dc.contributor.author Disenyane, Dineo
dc.contributor.author Bida, Meshack
dc.contributor.author Chikwati, Raylton
dc.contributor.author Snyman, Tracy
dc.contributor.author Martinson, Neil
dc.contributor.author Mahlangu, Johnny
dc.date.accessioned 2023-09-04T10:06:24Z
dc.date.available 2023-09-04T10:06:24Z
dc.date.issued 2023-08
dc.description DATA AVAILABILITY STATEMENT : Data are available upon reasonable request. en_US
dc.description.abstract AIM : We compared soluble transferrin receptors (sTfR), serum ferritin, mean cell volume (MCV) of red cells and the sTfR-ferritin index with the intensive method bone marrow trephine (BMT) iron stores in the diagnosis of iron deficiency anaemia (IDA) in Human Immunodeficiency Virus (HIV)-positive hospitalised participants. METHODS : In this cross-sectional study, we recruited hospitalised HIV-positive and coronavirus of 2019 (COVID-19)-negative adults with anaemia who required a bone marrow examination as part of their diagnostic workup. We measured the full blood count, ferritin, sTfR and assessed iron using the intensive method in Haemotoxylin and Eosin (H&E)-stained BMT core biopsies of consenting participants. RESULTS : Of the 60 enrolled participants, 57 were evaluable. Thirteen (22.80%) had IDA on H&E BMT iron stores assessment, and 44 (77.19%) had anaemia of chronic diseases (ACD). The sTfR and the sTfR-ferritin index had sensitivities of 61.54% and 53.85%, respectively, for IDA diagnosis. The sensitivity and specificity of ferritin was 7.69% and 92.31%, respectively. The sTfR and sTfR-ferritin index’s diagnostic specificity was relatively low at 46.15% and 38.46%, respectively. CONCLUSION : In this pilot study in HIV-positive participants, the prevalence of iron deficiency using the BMT assessment was low. Both the sTfR and the sTfR-ferritin index had a better quantitative correlation to bone marrow iron stores when compared with the MCV and ferritin and, may be more accurate surrogate markers of IDA. en_US
dc.description.department Anatomical Pathology en_US
dc.description.librarian hj2023 en_US
dc.description.uri https://jcp.bmj.com en_US
dc.identifier.citation Mankgele M, Variava E, Moloantoa T, et al. 2023, 'Underdiagnosis of iron deficiency anaemia in HIV-infected individuals : a pilot study using soluble transferrin receptors and intensive bone marrow iron stores to improve the diagnosis', Journal of Clinical Pathology, vol. 76, no. 8, pp. 555-560, doi : 10.1136/jcp-2022-208172. en_US
dc.identifier.issn 0021-9746 (print)
dc.identifier.issn 1472-4146
dc.identifier.other 10.1136/jcp-2022-208172
dc.identifier.uri http://hdl.handle.net/2263/92155
dc.language.iso en en_US
dc.publisher BMJ Publishing Group en_US
dc.rights © Author(s) (or their employer(s)) 2023. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license. en_US
dc.subject Soluble transferrin receptors (sTfR) en_US
dc.subject Serum ferritin en_US
dc.subject Mean cell volume (MCV) en_US
dc.subject Red cells en_US
dc.subject sTfR-ferritin index en_US
dc.subject Bone marrow trephine (BMT) en_US
dc.subject Iron deficiency anaemia (IDA) en_US
dc.subject Human immunodeficiency virus (HIV) en_US
dc.subject Hospitalisation en_US
dc.subject HIV-infected patients en_US
dc.subject.other Health sciences articles SDG-03
dc.subject.other SDG-03: Good health and well-being
dc.subject.other Health sciences articles SDG-17
dc.subject.other SDG-17: Partnerships for the goals
dc.title Underdiagnosis of iron deficiency anaemia in HIV-infected individuals : a pilot study using soluble transferrin receptors and intensive bone marrow iron stores to improve the diagnosis en_US
dc.type Article en_US


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