Author(s)

Debasish Chattopadhya^1,2*, Usha Baveja³

¹Centre for AIDS and Related Diseases, National Centre for Disease Control 22-Sham Nath Marg, Delhi, India.
²Department of Microbiology, Faculty of Medical and Health Sciences, SGT University, Gurgaon, India.
³Department of Pathology and Lab Medicine, Medanta the Medicity, Gurgaon, India.

Iron overload is reported to be associated with immune alterations and increased susceptibility to infections. HIV infection is characterized by progressive immunodeficiency leading to invasion by opportunistic pathogens. It was of interest to find out if disease course in HIV type-1 infection could have any relation with alteration in body iron status among individuals with history of oral iron intake. A follow-up study of immunologic and virologic markers in relation to disease progression was undertaken on asymptomatic HIV-1 positive blood donors with history of oral iron intake (subgroup I) compared to those without such history (subgroup II). High serum iron was associated with elevated levels of Th₂ category of cytokines, heightened immune activation, faster decline in CD4 + T lymphocyte count and higher viral set point. Pulmonary tuberculosis (PT) was the most common AIDS related illness (ARI) (>70%) recorded among subgroup I compared to non-PT category of ARI. Median ARI free duration (months) was shorter among those who developed PT compared to those developing non-PT category of ARI i.e. 30 (95% CI as 26,32) versus 67(95% CI as 60,71) in subgroup I and 47 (95% CI as 42,49) versus 80 (95% CI as 72,87) in subgroup II (P < 0.001 for PT versus non-PT in both subgroups). Median survival duration (months) in the PT versus non-PT categories of ARI was 47 (95% CI as 42,48) versus 95 (95% CI as 90,100) in subgroup I and 71 (95% CI as 65,76) versus 107 (95% CI as 102,112) in subgroup II (P < 0.001 for PT versus non-PT in both subgroups). The present study indicates that body iron overload resulting from excess intake of iron may be associated with qualitative defects in cell mediated immunity at early stage of HIV-1 infection that may facilitate subsequent acquisition of pulmonary tuberculosis, shorter ARI free duration and reduced survival.

Iron Overload, HIV-1, Cytokines, CD4 + T Lymphocyte, Pulmonary Tuberculosis

Chattopadhya, D. and Baveja, U. (2018) High Incidence of Pulmonary Tuberculosis in ART Naive Remunerated Blood Donors with Human Immunodeficiency Virus Type-1 Infection: Possible Role of Iron Overload. Journal of Biosciences and Medicines, 6, 62-82. doi: 10.4236/jbm.2018.62006.