Ray Amanda, Ndugwa Christopher, Mmirot Francis, Ricks Michelle O, Semba Richard D
Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Ann Trop Paediatr. 2007 Mar;27(1):11-6. doi: 10.1179/146532807X170457.
Iron deficiency is common in human immunodeficiency virus (HIV)-infected infants in sub-Saharan Africa. It is not known whether soluble transferrin receptor (sTfR) is a good indicator of iron deficiency in infants with HIV.
We evaluated sTfR as an indicator of iron deficiency in 134 HIV-infected 9-month-old infants in Kampala, Uganda. Ferritin <12 microg/L and microcytic, hypochromic anaemia were used as indicators of iron deficiency, respectively. The presence of inflammation was indicated by C-reactive protein >5 mg/L or alpha1-acid glycoprotein >1 g/L.
Receiver operator characteristic curves showed that the area under the curve was 0.67 when sTfR receptor was compared with low ferritin and 0.71 when sTfR was compared with microcytic, hypochromic anaemia. The appropriate calculated cut-offs of sTfR >3.74 microg/mL (43.98 nmol/L) and >3.53 microg/mL (41.55 nmol/L) show adequate specificities of 60% and sensitivities of 63% and 69% for low ferritin and microcytic, hypochromic anaemia, respectively. C-reactive protein and alpha 1-acid glycoprotein were strongly correlated with serum ferritin (r=0.371 and r=0.458, respectively, both p<0.0001) but were not correlated with sTfR (r=0.009 and r= -0.003, respectively, both p=0.9). In all, 78.6% of infants had alpha l-acid glycoprotein >1 g/L and 54.7% had C-reactive protein >5 g/L.
Soluble TfR appears to be an adequate indicator of iron deficiency in HIV-infected infants.
缺铁在撒哈拉以南非洲感染人类免疫缺陷病毒（HIV）的婴儿中很常见。目前尚不清楚可溶性转铁蛋白受体（sTfR）是否是HIV感染婴儿缺铁的良好指标。
我们在乌干达坎帕拉评估了134名9个月大的HIV感染婴儿的sTfR作为缺铁指标的情况。分别以铁蛋白<12μg/L和小细胞低色素性贫血作为缺铁指标。C反应蛋白>5mg/L或α1酸性糖蛋白>1g/L表明存在炎症。
受试者工作特征曲线显示，当sTfR受体与低铁蛋白比较时，曲线下面积为0.67；当sTfR与小细胞低色素性贫血比较时，曲线下面积为0.71。计算得出的sTfR合适临界值>3.74μg/mL（43.98nmol/L）和>3.53μg/mL（41.55nmol/L），对于低铁蛋白和小细胞低色素性贫血分别显示出60%的足够特异性和63%以及69%的敏感性。C反应蛋白和α1酸性糖蛋白与血清铁蛋白高度相关（分别为r = 0.371和r = 0.458，均p<0.0001），但与sTfR不相关（分别为r = 0.009和r = -0.003，均p = 0.9）。总体而言，78.6%的婴儿α1酸性糖蛋白>1g/L，54.7%的婴儿C反应蛋白>5g/L。
可溶性转铁蛋白受体似乎是HIV感染婴儿缺铁的一个合适指标。
