Markers of microbial translocation predict hypertension in HIV-infected individuals

被引：56

作者：

Manner, I. W. ^{[1
,2
,3
]}

Baekken, M. ^{[1
]}

Kvale, D. ^{[2
,3
]}

Oektedalen, O. ^{[2
]}

Pedersen, M. ^{[4
]}

Nielsen, S. D. ^{[5
]}

Nowak, P. ^{[6
]}

Os, I. ^{[1
,3
]}

Troseid, M. ^{[2
]}

机构：

[1] Oslo Univ Hosp, Dept Nephrol, N-0424 Oslo, Norway

[2] Oslo Univ Hosp, Dept Infect Dis, N-0424 Oslo, Norway

[3] Univ Oslo, Inst Clin Med, Fac Med, Oslo, Norway

[4] Univ Copenhagen, Rigshosp, Fac Hlth Sci, Ctr Inflammat & Metab, DK-2100 Copenhagen, Denmark

[5] Univ Copenhagen Hosp, Dept Infect Dis, Rigshosp, DK-2100 Copenhagen, Denmark

[6] Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden

来源：

HIV MEDICINE | 2013年 / 14卷 / 06期

关键词：

HIV infection; hypertension; lipopolysaccharide; nadir CD4 cell count; soluble CD14;

D O I：

10.1111/hiv.12015

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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 (sCD14)], 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% 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 66-272pg/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.

引用

页码：354 / 361

页数：8

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