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Int J Tuberc Lung Dis. 2014 Nov;18(11):1337-9. doi: 10.5588/ijtld.14.0143.

Elevated hepcidin at HIV diagnosis is associated with incident tuberculosis in a retrospective cohort study.

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Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Medical Research Council Unit (UK), Fajara, The Gambia.
International Nutrition Group, Department of Nutrition and Public Health Intervention Unit, London School of Hygiene & Tropical Medicine, London, UK.


Hepcidin inhibits ferroportin-mediated iron efflux, leading to intracellular macrophage iron retention, possibly favoring Mycobacterium tuberculosis iron acquisition and tuberculosis (TB) pathogenesis. Plasma hepcidin was measured at human immunodeficiency virus (HIV) diagnosis in a retrospective HIV-prevalent, antiretroviral-naïve African cohort to investigate the association with incident pulmonary and/or extra-pulmonary TB. One hundred ninety-six participants were followed between 5 August 1992 and 1 June 2002, with 32 incident TB cases identified. Greater hepcidin was associated with significantly increased likelihood of TB after a median time to TB of 6 months. Elucidation of iron-related causal mechanisms and time-sensitive biomarkers that identify individual changes in TB risk are needed.

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