The role of hepcidin in the pathogenesis of anemia in Zimbabwean infants (1034.1)

Abstract

Anemia is common in sub‐Saharan African infants, particularly in the context of HIV infection. Hepcidin is the major hormone regulating iron metabolism but its role in the pathogenesis of anemia during infancy is unclear. The aim of this study was to characterize hepcidin concentrations in anemic and non‐anemic infants and in HIV‐infected and HIV‐exposed uninfected (HEU) infants. Archived plasma samples from HIV‐unexposed (n=289), HIV‐exposed uninfected (HEU; n=354) and HIV‐infected (n=264) anemic and non‐anemic Zimbabwean infants at 3, 6 and 12mo of age were used to measure hepcidin, ferritin, transferrin receptor, AGP and CRP by ELISA. We undertook multivariate analysis of hepcidin, HIV and anemia status, adjusting for sex and age. Hepcidin concentrations were higher in HIV‐infected compared to HEU and HIV‐unexposed groups throughout infancy and higher in HEU compared to HIV‐unexposed infants. Hepcidin concentrations were correlated with levels of ferritin and CRP. Overall, anemia was not associated with hepcidin concentrations during infancy, except in HIV‐unexposed infants. Hepcidin declined with age in all groups; girls had higher hepcidin concentrations than boys. Plasma hepcidin concentrations are positively associated with inflammation in infants, as has been shown in adults. Future studies should explore whether elevated hepcidin contributes to the pathogenesis of HIV infection.Grant Funding Source: Supported by the Bill and Melinda Gates Foundation (OPP1021542); Department for International Develo