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Markers of microbial translocation predict hypertension in HIV ‐infected individuals
Author(s) -
Manner IW,
Baekken M,
Kvale D,
Oektedalen O,
Pedersen M,
Nielsen SD,
Nowak P,
Os I,
Trøseid M
Publication year - 2013
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12015
Subject(s) - medicine , interquartile range , blood pressure , nadir , cd14 , gastroenterology , immunology , engineering , aerospace engineering , satellite , receptor
Objectives The aim of the study was to test the hypothesis that microbial translocation, quantified by levels of lipopolysaccharide ( LPS ) and subsequent monocyte activation [soluble (s CD14 )], is associated with hypertension in HIV ‐infected individuals. Methods In this exploratory substudy, 42 patients were recruited from a larger, longitudinal HIV ‐infected cohort study on blood pressure. LPS and sCD14 levels were measured retrospectively at the time of nadir CD4 cell count, selecting untreated HIV ‐infected patients with both advanced immunodeficiency and preserved immunocompetence at the time of nadir. Patients with later sustained hypertension ( n = 16) or normotension ( n = 26) throughout the study were identified. LPS was analysed using the Limulus Amebocyte Lysate colorimetric assay (Lonza, Walkersville, MD ) and sCD14 using an enzyme‐linked immunosorbent assay ( ELISA ). Nonparametric statistical tests were applied. Results In the HIV ‐infected patients [median (interquartile range) age 42 (32–46) years; 79% male and 81% C aucasian], LPS and sCD14 levels were both negatively correlated with nadir CD4 cell count. Plasma levels of LPS ( P < 0.001) and sCD14 ( P = 0.024) were elevated in patients with later hypertension compared with patients with normotension. There was a stepwise increase in the number of patients with hypertension across tertiles of LPS ( P = 0.001) and sCD14 ( P = 0.007). Both LPS and sCD14 were independent predictors of elevated blood pressure after adjustment for age and gender. For each 10‐unit increase in LPS (range 66–272 pg/ml), the increment in mean blood pressure in the first period of blood pressure recording was 0.86 (95% confidence interval 0.31–1.41) mmHg ( P = 0.003). Conclusions As LPS and sCD14 were both independently associated with elevated blood pressure, microbial translocation may be linked to the development of hypertension.