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. 2013 Nov;22(11):2084-93.
doi: 10.1158/1055-9965.EPI-13-0614. Epub 2013 Sep 17.

Serum biomarkers of immune activation and subsequent risk of non-hodgkin B-cell lymphoma among HIV-infected women

Shehnaz K Hussain  1 , Nancy A Hessol, Alexandra M Levine, Elizabeth Crabb Breen, Kathryn Anastos, Mardge Cohen, Gypsyamber D'Souza, Deborah R Gustafson, Sylvia Silver, Otoniel Martínez-Maza
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Serum biomarkers of immune activation and subsequent risk of non-hodgkin B-cell lymphoma among HIV-infected women

Shehnaz K Hussain et al. Cancer Epidemiol Biomarkers Prev. 2013 Nov.

Abstract

Background: There is increasing evidence that chronic immune activation predisposes to non-Hodgkin lymphoma (NHL). Whether this association exists among women representative of the current HIV epidemic in the United States who are at high risk of HIV-associated NHL (AIDS-NHL), remains to be determined.

Methods: We conducted a nested case-control study within the Women's Interagency HIV Study with longitudinally collected risk factor data and sera. Cases were HIV-infected women with stored sera collected at three time-windows 3 to 5 years, 1 to 3 years, and 0 to 1 year before AIDS-NHL diagnosis (n = 22). Three to six HIV-infected controls, without AIDS-NHL, were matched to each case on age, race, CD4(+) T-cell count, and study follow-up time (n = 78). ORs and 95% confidence intervals (CI) for the association between one unit increase in log-transformed biomarker levels and AIDS-NHL were computed using random effect multivariate logistic regression models.

Results: Elevated levels of sCD27 (OR = 7.21; 95% CI, 2.62-19.88), sCD30 (OR = 2.64; 95% CI, 1.24-5.64), and CXCL13 (OR = 2.56; 95% CI, 1.32-4.96) were associated with subsequent diagnosis of AIDS-NHL overall. Elevated sCD23 was associated with a two to three-fold increased risk of AIDS-NHL in certain subgroups, whereas elevated interleukin 6 was associated with a two-fold increased risk in the 0 to 1 year time-window, only.

Conclusions: These findings support the hypothesis that chronic B-cell activation contributes to the development of AIDS-NHL in women.

Impact: Soluble CD23 (sCD23), sCD27, sCD30, and CXCL13 may serve as biomarkers for AIDS-NHL.

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Conflict of interest statement

Conflicts of Interest: None of the authors have a conflict of interest to report.

Figures

Figure 1
Figure 1. Mean serum biomarker levels in AIDS-NHL cases and matched HIV-infected controls
Geometric means for cases (black diamonds) and controls (black circles) and 95% confidence intervals (bars) at three time-windows preceding an AIDS-NHL diagnosis in cases and reference date in controls for a. sCD23, b. sCD27, c. sCD30, d. CXCL13, e. IL6, and f. CRP. P-values represent the significance level for the difference in mean biomarker values between cases and matched controls.
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