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Markers of microbial translocation and risk of AIDS-related lymphoma

Marks, Morgan A.a; Rabkin, Charles S.a; Engels, Eric A.a; Busch, Evanb; Kopp, Williamc; Rager, Helenc; Goedert, James J.a; Chaturvedi, Anil K.a

doi: 10.1097/QAD.0b013e32835c1333
Epidemiology and Social: CONCISE COMMUNICATION

Background: Depletion of gut-associated lymphocytes by HIV infection facilitates microbial translocation, which may contribute to non-Hodgkin lymphoma (NHL) risk via chronic immune activation and B-cell hyperstimulation.

Method: We therefore examined associations of four microbial translocation markers with subsequent NHL risk in a case–control study nested within four prospective cohort studies of HIV-infected individuals. Prediagnostic blood specimens for 56 NHL cases and 190 controls matched for age, sex, race, specimen type, cohort, and CD4+ T-cell count were tested for the endotoxin lipopolysaccharide (LPS), antiendotoxin core antibody (EndoCab), LPS-binding protein (LBP), and soluble CD14 (sCD14).

Results: Elevated levels of sCD14 were associated with significantly increased NHL risk [odds ratio (OR) 2.72 (95% confidence interval [95% CI] 1.29–5.76)]. In subgroup analyses, elevated LPS levels were also associated with significantly increased NHL risk [OR 3.24 (95% CI 1.10–9.53)]. EndoCab and LBP levels were not associated with NHL risk.

Conclusion: The association of sCD14 and LPS with NHL risk supports an etiologic role for gut microbial translocation in lymphomagenesis among HIV-infected individuals. Additional studies with larger sample sizes are needed to confirm these observations.

aInfections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland

bDepartment of Epidemiology, University of North Carolina, Chapel Hill, North Carolina

cClinical Support Laboratory, SAIC-Frederick Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA.

Correspondence to Morgan A. Marks, 6120 Executive Blvd, EPS/7055 Rockville, MD, USA. Tel: +1 301 451 4894; e-mail:

Received 12 September, 2012

Revised 21 October, 2012

Accepted 30 October, 2012

© 2013 Lippincott Williams & Wilkins, Inc.