Drawing on findings from three complementary studies conducted in South Africa, the work provides the most comprehensive analysis to date of iron metabolism in children living with virally suppressed HIV. The findings, published in Nature Communications, provide a strong evidence base to guide recommendations and policies for preventing and managing iron deficiency in paediatric HIV.
Iron deficiency anaemia is common in children living with HIV and is associated with poorer health outcomes and higher mortality. While iron supplementation is recommended to prevent and treat iron deficiency in children without HIV, there is uncertainty about whether HIV-related inflammation may limit iron absorption. This could leave more unabsorbed iron in the gut, which may disrupt the gut microbiome and increase the risk of other infections, especially in places with much infectious disease.
To address key knowledge gaps and explore new approaches to iron intervention, researchers from King’s College London, Stellenbosch University, ETH Zurich, and the University of Oxford conducted three studies examining iron absorption, losses, and responses to current iron interventions in children with virally suppressed HIV and iron deficiency.
The studies' findings could help shape safer, more effective nutrition strategies for children with HIV and potentially for other conditions where inflammation and gut health affect how the body absorbs and uses iron.
Michael B. Zimmermann, Professor of Human Nutrition at the Radcliffe Department of Medicine and Principal Investigator of the project, said:
Previous studies in African children have raised concerns that iron supplementation can increase the risk of respiratory and gastrointestinal infections, particularly in settings with high infectious disease burdens. Our findings suggest that combining iron with prebiotics, specifically galacto-oligosaccharides, may offer a promising strategy to improve the safety of iron supplementation in children with HIV by supporting gut health and reducing infection-related symptoms.
Read the full story from King's College London.
Read the paper in Nature Communications: Iron absorption and loss, and efficacy of iron supplementation with and without prebiotics in children with virally suppressed HIV: three prospective studies in South Africa