International Journal of Contemporary Pediatrics | October-December 2015 | Vol 2 | Issue 4 Page 349 International Journal of Contemporary Pediatrics Kumar D et al. Int J Contemp Pediatr. 2015 Nov;2(4):349-352 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Research Article Serum ferritin levels in human immunodeficiency virus infected children and its relation with severe immunodeficiency Durgesh Kumar 1 *, Mukesh Vir Singh 1 , Indra Kumar Sharma 1 , Dinesh Kumar 1 , Krishan Mohan Shukla 1 , Dhamendra Kumar Singh 2 INTRODUCTION Ferritin is a 24-subunit evolutionarily conserved protein. Within the cytosol, its main function is to store iron in a soluble nontoxic form, protecting the cell from iron- mediated oxidation-reduction reactions. In the circulation, it acts as a delivery mechanism, and serum levels usually reflect total body iron stores. 1 However, despite physiological regulation of iron homeostasis, the proportionality does not always hold true and a host of conditions have been implicated to cause markedly elevated serum ferritin levels. 2-4 Interpretation of an elevated serum ferritin value will vary significantly depending on the patient population and local epidemiology. 2,3 It can be abnormally elevated in a wide range of disease states including malignancy, infection, inflammation, and chronic iron-overload syndromes. Previous investigators have examined the underlying causes of markedly elevated ferritin levels. Liver disease, malignancy, and renal disease have been found to be prominent causes, 2 and infections predominated in a recent HIV-positive cohort. 5 ABSTRACT Background: Ferritin is an acute phase protein which is often elevated in acute and chronic inflammation. In adults with human immunodeficiency virus (HIV) infection, elevated serum ferritin levels indicate advanced or progressive disease. In the present study, ferritin levels were evaluated in HIV infected children to find out its relation with the immune deficiency. Methods: The children who were HIV positive (confirmed by ELISA for HIV-1 and HIV-2), and attending the OPD of ART Centre and of tertiary care center during period of one year were included in the study. The study population consisted of 47 patients, belonging to both sexes and age of 18 months to 19 years. Detailed history was taken and full clinical examination done in all cases. Blood sample for Complete blood count, serum ferritin and CD4 count was taken. Absolute CD4 count of each patient was obtained and immunological staging was done on the basis of WHO immunological staging criteria. Serum ferritin level 7-140 ngm/mL was considered normal. Results: Hyperferritenimia (>140 ngm/ mL) is a feature of advanced stages of HIV infection. 11.1% patients of stage 3 and 40.0% patients of stage 4 are showing hyperferritinemia (r = 0.890), irrespective of anemia. Low serum ferritin level (<7 ngm/mL) is an unusual feature in HIV infected children. Conclusions: High Serum ferritin levels are not uncommon in children with HIV disease and they are related with immunological progression of the disease. Keywords: HIV, Serum ferritin, CD4 count, Immunological stage 1 Department of Pediatrics, UP Rural Institute of Medical Sciences and Research, Saifai, Etawah, Uttar Pradesh, India 2 Department of Pediatrics, MLN Medical College, Allahabad, Uttar Pradesh, India Received: 22 July 2015 Revised: 23 August 2015 Accepted: 20 September 2015 *Correspondence: Dr. Durgesh Kumar, E-mail: drdurgeshk@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20150972