%0 Journal Article %A Mahlatse Mankgele %A Ebrahim Variava %A Tumelo Moloantoa %A Kennedy Otwombe %A Khuthadzo Hlongwane %A Dineo Disenyane %A Meshack Bida %A Raylton Chikwati %A Tracy Snyman %A Neil Martinson %A Johnny Mahlangu %T Underdiagnosis of iron deficiency anaemia in HIV-infected individuals: a pilot study using soluble transferrin receptors and intensive bone marrow iron stores to improve the diagnosis %D 2022 %R 10.1136/jcp-2022-208172 %J Journal of Clinical Pathology %P jclinpath-2022-208172 %X Aim We compared soluble transferrin receptors (sTfR), serum ferritin, mean cell volume (MCV) of red cells and the sTfR-ferritin index with the intensive method bone marrow trephine (BMT) iron stores in the diagnosis of iron deficiency anaemia (IDA) in Human Immunodeficiency Virus (HIV)-positive hospitalised participants.Methods In this cross-sectional study, we recruited hospitalised (HIV)-positive and coronavirus of 2019 (COVID-19)-negative adults with anaemia who required a bone marrow examination as part of their diagnostic workup. We measured the full blood count, ferritin, sTfR and assessed iron using the intensive method in Haemotoxylin and Eosin (H&E)-stained BMT core biopsies of consenting participants.Results Of the 60 enrolled participants, 57 were evaluable. Thirteen (22.80%) had IDA on H&E BMT iron stores assessment, and 44 (77.19%) had anaemia of chronic diseases (ACD). The sTfR and the sTfR-ferritin index had sensitivities of 61.54% and 53.85%, respectively, for IDA diagnosis. The sensitivity and specificity of ferritin was 7.69% and 92.31%, respectively. The sTfR and sTfR-ferritin index’s diagnostic specificity was relatively low at 46.15% and 38.46%, respectively.Conclusion In this pilot study in HIV-positive participants, the prevalence of iron deficiency using the BMT assessment was low. Both the sTfR and the sTfR-ferritin index had a better quantitative correlation to bone marrow iron stores when compared with the MCV and ferritin and, may be more accurate surrogate markers of IDA.Data are available upon reasonable request. %U https://jcp.bmj.com/content/jclinpath/early/2022/09/27/jcp-2022-208172.full.pdf