Markers of microbial translocation predict hypertension in HIV-infected individuals
Article first published online: 17 JAN 2013
© 2013 British HIV Association
Volume 14, Issue 6, pages 354–361, July 2013
How to Cite
Manner, I., Baekken, M., Kvale, D., Oektedalen, O., Pedersen, M., Nielsen, S., Nowak, P., Os, I. and Trøseid, M. (2013), Markers of microbial translocation predict hypertension in HIV-infected individuals. HIV Medicine, 14: 354–361. doi: 10.1111/hiv.12015
- Issue published online: 6 JUN 2013
- Article first published online: 17 JAN 2013
- Manuscript Accepted: 5 DEC 2012
- Signe and Albert Bergsmarken's fund
- Oslo University Hospital
- South-Eastern Norway Regional Health Authority
- Novo Nordisk Foundation
- HIV infection;
- nadir CD4 cell count;
- soluble CD14
The aim of the study was to test the hypothesis that microbial translocation, quantified by levels of lipopolysaccharide (LPS) and subsequent monocyte activation [soluble (sCD14)], is associated with hypertension in HIV-infected individuals.
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.
In the HIV-infected patients [median (interquartile range) age 42 (32–46) years; 79% male and 81% Caucasian], 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).
As LPS and sCD14 were both independently associated with elevated blood pressure, microbial translocation may be linked to the development of hypertension.