OBJECTIVES : The purpose of this study was to evaluate markers of iron status and
inflammation/oxidative stress in maternal and cord blood (CB) of HIV-infected and HIVuninfected
women as potential mechanisms for poor outcomes among HIV-exposed, uninfected
METHODS : Maternal venous and cord blood (CB) specimens were obtained from eighty-seven
pregnant women (45 HIV-infected and 42 HIV-uninfected) enrolled at Kalafong Hospital,
Pretoria, South Africa. Iron status (serum iron, ferritin, transferrin, transferrin saturation, soluble
transferrin receptor [sTfR], sTfR/log ferritin [sTfR/F index], antenatal exposure to inflammation
(CB C-reactive protein, interleukin-6, haptoglobin switch-on status) and oxidative stress (total
radical trapping ability of CB plasma [TRAP], and chronic oxidative stress (soluble receptor of
advanced glycation end-products [sRAGE]) were assessed by laboratory studies.
RESULTS : There were no differences in maternal hematological and iron indices except that HIVinfected
mothers had decreased WBC counts (P=0.048) and increased serum ferritin (P=0.032).
Ferritin levels were significantly higher in CB than in maternal blood (P<0.001) in both groups
and further elevated in the CB of HEU infants (P=0.044). There was also an inverse relationship
between CB sTfR/F index and sRAGE (r=-0.43, P=0.003) in the HIV-infected but not HIVuninfected
CONCLUSIONS : Our study shows for the first time that ferritin is significantly elevated in CB of
HEU infants. The inverse relationship between sTfR/F index and sRAGE in CB suggests that
chronic oxidative stress or RAGE axis activation in HIV-infected mothers may play a role in
modulating ferritin levels.