Microbial translocation and AIDS-associated lymphomas: crux of the problem.

In this issue of AIDS, Marks et al. [1] have reported significant associations between markers of microbial translocation and increased risk for non-Hodgkin’s lymphoma (NHL) in HIV-infected individuals. The authors examined prediagnostic blood samples from NHL and non-NHL HIV-infected individuals for different markers of microbial translocation. The results show that elevated plasma levels of sCD14 associated independently with 2.5-fold increased risk for NHL. The authors used Limulus Amebocyte Lysate Assay for measuring lipopolysaccharide (LPS). As plasma/serum contains substances that interfere with the assay, the authors measured percentage recovery of LPS from each sample after spiking it with LPS. Considering the samples from which they recovered the recommended (50–200) percentage of the spiked LPS, they found significant associations of the above-median values with increased (3.0-fold) risk for NHL. These results suggest, for the first time, an etiologic role of microbial translocation across gut mucosa in lymphomagenesis in HIV-infected individuals.