title: Markers of microbial translocation predict hypertension in HIV-infected individuals.
abstract: OBJECTIVE
  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 66-272 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.
authors: Department of Nephrology, Oslo University Hospital, Oslo, Norway.
authors: I W
authors: IW
authors: Manner
authors: M
authors: M
authors: Baekken
authors: D
authors: D
authors: Kvale
authors: O
authors: O
authors: Oektedalen
authors: M
authors: M
authors: Pedersen
authors: S D
authors: SD
authors: Nielsen
authors: P
authors: P
authors: Nowak
authors: I
authors: I
authors: Os
authors: M
authors: M
authors: Trøseid
mesh_terms: D000328:Adult; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008033:Limulus Test; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D015415:Biomarkers; D018950:Lipopolysaccharide Receptors; D008070:Lipopolysaccharides