Mankgele, MahlatseVariava, EbrahimMoloantoa, TumeloOtwombe, KennedyHlongwane, KhuthadzoDisenyane, DineoBida, MeshackChikwati, RayltonSnyman, TracyMartinson, NeilMahlangu, Johnny2023-09-042023-09-042023-08Mankgele 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-2022-208172.0021-9746 (print)1472-414610.1136/jcp-2022-208172http://hdl.handle.net/2263/92155DATA AVAILABILITY STATEMENT : Data are available upon reasonable request.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© 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.Soluble transferrin receptors (sTfR)Serum ferritinMean cell volume (MCV)Red cellssTfR-ferritin indexBone marrow trephine (BMT)Iron deficiency anaemia (IDA)Human immunodeficiency virus (HIV)HospitalisationHIV-infected patientsHealth sciences articles SDG-03SDG-03: Good health and well-beingHealth sciences articles SDG-17SDG-17: Partnerships for the goalsArticle