Iron supplementation for reducing morbidity and mortality in children with HIV
Anaemia is one of the most common haematologic problem found in children with HIV/AIDS, second only to depletion of CD4/helper T lymphocytes. Anaemia in HIV-infected children can be caused by direct effects of HIV, other prevalent infections and opportunistic infections on blood producing cells; micronutrient deficiencies; or side effects of drugs used to prevent or treat opportunistic infections and HIV. Deficiency of iron, a micronutrient, is by far the most common cause of nutritional anaemia worldwide. Given the global prevalence of iron deficiency anaemia, especially in parts of the world where childhood HIV infections are quite prevalent, it is likely many HIV-infected children also are iron deficient. There is very little known, however, about the contribution of iron deficiency to anaemia observed in children with HIV/AIDS. Iron supplementation currently is given routinely to anaemic children in most of the developing countries where there also are high rates of HIV infection, and no obvious adverse effects have been observed. However, there are reports of a deleterious effect of iron supplementation during ongoing infections, including malaria. As iron deficiency and iron deficiency anaemia are common in HIV-infected children in high-prevalence areas with concerns about possible deleterious effects of iron, we looked for randomised clinical trials that demonstrated benefits or disadvantages of iron supplements, regardless of type or preparation. We did not find any such trials and conclude that there is a need for large multi-centre trials to examine these questions.
Adetifa, I.; Okomo, U. Iron supplementation for reducing morbidity and mortality in children with HIV. Cochrane Database of Systematic Reviews (2009) (Issue 1) Art. No.: CD006736. [DOI: 10.1002/14651858.CD006736.pub2]