Original Research

Effect of dolutegravir on ferritin, iron, and C-reactive protein among people living with HIV and co-infections

Bridget Kamurai, Raylton P. Chikwati, Donald Vhanda, Terrence Nyamayaro, Justen Manasa, Vinie Kouamou
Southern African Journal of HIV Medicine | Vol 25, No 1 | a1543 | DOI: https://doi.org/10.4102/sajhivmed.v25i1.1543 | © 2024 Bridget Kamurai, Raylton P. Chikwati, Donald Vhanda, Terrence Nyamayaro, Justen Manasa, Vinie Kouamou | This work is licensed under CC Attribution 4.0
Submitted: 09 October 2023 | Published: 30 April 2024

About the author(s)

Bridget Kamurai, Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
Raylton P. Chikwati, Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Donald Vhanda, Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
Terrence Nyamayaro, Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
Justen Manasa, Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
Vinie Kouamou, Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe

Abstract

Background: Dolutegravir-based antiretroviral therapy (ART) is currently recommended as the preferred first-line ART in many resource-limited settings. However, little is known about the clinical experience of dolutegravir within a context of prevalent co-infections.

Objectives: To assess virological outcomes, and iron, ferritin and C-reactive protein (CRP) levels among people living with HIV (PLWH) and co-infections after initiating or re-initiating dolutegravir-based ART.

Method: This prospective study was conducted between August 2022 and August 2023. Study participants were recruited from an HIV opportunistic infection clinic. Screening for co-infections (syphilis, hepatitis B virus, cytomegalovirus and herpes simplex virus) was performed at baseline, prior to ART initiation. Plasma HIV viral load (VL), CRP, ferritin and iron levels were measured at baseline and at the 6-month follow-up period.

Results: A total of 100 participants (51 women and 49 men) were enrolled in this study. The median age of the participants was 39 years. The prevalence of co-infections was 30%. Prior to ART initiation, participants with co-infections had higher VL, CRP and ferritin, and lower iron levels, compared to those without co-infections (P < 0.001). Following 6 months of ART, CRP and ferritin levels decreased while iron levels increased, regardless of co-infection status. However, CRP and ferritin remained significantly higher in those with co-infections despite similar and high rates of virologic suppression in both groups.

Conclusion: The presence of co-infections in PLWH is associated with higher VL and with chronic inflammation. Ferritin and CRP decreased on dolutegravir-based ART but remained higher in people with co-infections despite similar rates of virologic suppression.


Keywords

HIV; co-infections; ferritin; iron; virological outcomes; dolutegravir

Sustainable Development Goal

Goal 3: Good health and well-being

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