Abstract

ABSTRACTBackgroundWe assessed zinc protoporphyrin (ZPP) and the percentage of hypochromic erythrocytes in patients with advanced acquired immunodeficiency syndrome (AIDS) treated with recombinant erythropoietin (rhEPO).MethodsPatients received 150 IU rhEPO subcutaneously every second day for 10 days, and 150 IU rhEPO plus 62.5 mg of intravenous iron every second day for an additional 10 days.ResultsBefore rhEPO therapy, ZPP was at 64.3 ± 27.3 μmol/mol heme and the percentage of hypochromic erythrocytes was elevated at 9.7%, indicating mild functional iron deficiency. Ferritin was 1,002 ± 956 μg/L, with transferrin saturation of 19.1 ± 9.7%. Under rhEPO alone, ZPP rose to 80.1 ± 21.6 μmol/mol heme and the percentage of hypochromic red cells rose to 22.9 ± 4.7%; ferrtin fell to 705 ± 601 μg/L and transferrin saturation fell to 12 ± 6.3%. When rhEPO was supplemented with iron, ZPP fell to 70.4 ± 20.5 μmol/mol heme, the percentage of hypochromic red cells fell to 14.7 ± 3.4%; ferritin was unchanged at 771 ± 62 μg/L and transferrin saturation rose to 20.5 ± 5.5%.ConclusionsIn contrast to ferritin and transferrin saturation, ZPP and the percentage of hypochromic erythrocytes effectively detect the functional iron deficiency under rhEPO therapy in advanced AIDS.