FERRITIN AS A BIOMARKER OF INFLAMMATION AND IRON METABOLISM IN PEOPLE LIVING WITH HIV: CURRENT CLINICAL EVIDENCE

Abstract

 Ferritin is a widely used biomarker of iron storage and has an important role in the assessment of iron metabolism. However, ferritin is also an acute-phase protein whose concentration may increase in response to inflammation, infection, and immune activation. These characteristics are particularly relevant in people living with human immunodeficiency virus, who may experience persistent immune activation and chronic inflammation even in the presence of effective antiretroviral therapy. This review examines the current
evidence regarding the role of ferritin as a biomarker of inflammation and iron metabolism in people living with human immunodeficiency virus. This narrative review was conducted through literature searches in PubMed/MEDLINE and Scopus using keywords related to HIV, ferritin, inflammation, iron metabolism, hepcidin, anemia, and antiretroviral therapy. Relevant publications were screened based on their relevance to ferritin, inflammation, and iron homeostasis in people living with HIV. A total of 14 relevant articles were included in the narrative synthesis. Current evidence indicates that ferritin concentrations may reflect a complex interaction between iron stores, inflammation, immune activation, nutritional status, and treatmentrelated factors. Therefore, elevated ferritin should not be interpreted solely as evidence of increased iron stores, particularly in the presence of chronic inflammation. Understanding the biological context of ferritin measurement may improve its interpretation and support more appropriate assessment of iron status and inflammatory conditions in people living with human immunodeficiency virus.