Nominated From: University of Minnesota
Research Site: Kenya
Research Area: Infectious Disease
Primary Mentor: Chandy John
Interactions of HIV and Malaria with Iron Deficiency
In the present study, we aim to assess whether iron deficiency is more frequent in adults with HIV infection, and whether it is protective against malaria in children living in a malaria endemic area. The study questions can be answered with samples from established cohorts, and they will provide the basis for future research studies on iron supplementation and malaria risk in these two populations
1.Determine whether iron deficiency is associated with protection against clinical malaria in children living in an area of high malaria transmission. We hypothesize, based on an earlier study in Tanzania, that iron deficiency will be associated with protection from clinical malaria.
2.Establish the prevalence of iron deficiency in individuals with newly diagnosed HIV infection as compared to HIV-uninfected adults. We hypothesize that adults with HIV infection will have more iron deficiency than adults without HIV infection
Iron deficiency anemia affects 800 million people annually, including 42 million African children <5 years of age. Early studies of iron supplementation showed an increased risk of death with iron supplementation in children in malaria endemic areas, but a recent study in which children had rapid access to malaria treatment showed no increased risk with supplementation. In addition, a single study in Tanzania showed a decreased risk of malaria and death in children with iron deficiency as compared to iron sufficient children, but no subsequent studies have confirmed these results. Together, the studies suggest that iron supplementation of children in malaria endemic areas may be complicated, particularly if close follow-up for malaria cannot be insured. A critical first step in assessment of risk is determining if the association of iron deficiency with protection from clinical malaria is present in another site of high malaria transmission. Iron supplementation in individuals with HIV, particularly adults, has not been extensively studied. A recent study suggested that iron supplementation might be good for delaying progression of HIV, but bad in terms of malaria risk. There are very few studies of iron deficiency in adults with HIV, but their state of chronic low-level inflammation might put them at risk for iron deficiency. Many are anemic and routinely given iron supplementation, but the benefits and risks of this supplementation have not been defined. In particular, it is unclear whether iron supplementation increases the risk of malaria in patients with HIV.