Positive association between dietary iron intake and iron status in HIV-infected children in Johannesburg, South Africa
Date
2013Author
Kruger, Herculina S.
Balk, Lisanne J.
Viljoen, Michelle
Meyers, Tammy M.
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Show full item recordAbstract
Anemia is a common complication of pediatric HIV infection and is associated with
suboptimal cognitive performance and growth failure. Routine iron supplementation is not
provided to South African HIV-infected children. We hypothesized that dietary iron intake
without supplementation is sufficient to protect against iron deficiency (ID) in HIV-infected
children receiving highly active antiretroviral therapy. In this prospective study, the
difference between dietary intakes of iron-deficient children (soluble transferrin receptor
>9.4 mg/L) and iron-sufficient children after 18 months on highly active antiretroviral
therapy was examined. The association between iron intake and hemoglobin (Hb)
concentration was also assessed. Longitudinal data collected for 18 months from 58 HIVinfected
African children were assessed by generalized estimation equations, with
adjustment for demographic information, dietary intakes, growth parameters, and CD4%.
After adjustment for covariates, the longitudinal association between dietary iron intake
and Hb concentration remained significant. This association shows that for every 1-mg
increase in iron intake per day, Hb increases by 1.1 g/L (P < .001). Mean Hb increased
significantly after 18 months of follow-up (106 ± 14 to 129 ± 14 g/L, P < .01), but soluble
transferrin receptor also increased (7.7 ± 2.7 to 8.9 ± 3.0 mg/L, P < .01). The incidence of ID
increased from 15.2% at baseline to 37.2% after 18 months. Children with animal protein
intakes greater than >20 g/d had significantly lower odds for ID at 18 months than did
children with lower intakes (odds ratio, 0.40; 95% confidence interval, 0.21-0.77). Dietary iron
intake was insufficient to protect against ID, pointing to a need for low-dose iron
supplementation for iron-deficient HIV-infected children and interventions to increase
the consumption of animal protein.
URI
http://hdl.handle.net/10394/15144https://www.sciencedirect.com/science/article/pii/S0271531712002473
https://doi.org/10.1016/j.nutres.2012.11.008
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