People with HIV/AIDS are at increased risk for developing certain cancers, particularly non-Hodgkin's lymphoma (NHL). Doctors have no way of predicting which of their HIV-positive patients will develop this cancer. According to a research team at the University of California at Los Angeles, a protein called CD27 may be linked to the appearance of NHL.
This discovery should not be entirely surprising since high levels of CD27 have been found in the blood of people with certain infections and who suffer from auto-immune disorders (conditions in which the immune system attacks itself). When cells release CD27 protein into the blood, the protein becomes what's called soluble CD27 or sCD27.
Just as regular monitoring of CD4+ and CD8+ cell levels can help doctors take better care of their patients, monitoring sCD27 levels may help them predict who is at risk of developing NHL. The results from this UCLA study are, therefore, exciting. If confirmed by independent researchers, sCD27 monitoring may prove to be a major advance in the care of people with HIV/AIDS.
Technicians collected blood samples to measure sCD27 levels from four groups of subjects:
Later in this article, we present the breakdown of sCD27 levels among the four groups of subjects. The sCD27 levels reported represent the halfway point in each group. By this we mean that 50 per cent of subjects in each group had sCD27 levels below this level, and the remaining 50 per cent had levels above this figure. sCD27 levels are given in units per millilitre (U/ml).
Upon analysing the data, the researchers found that sCD27 levels were twice as high among subjects who later developed lymphoma than in subjects with AIDS who did not get this cancer. This difference was statistically significant: not likely due to chance alone.
After examining the data, researchers set a cut-off point of 500 U/ml to help them calculate the risk of developing NHL. They found that subjects with sCD27 levels greater than 500 were 13 times more likely to get lymphoma than subjects with lower CD27 levels. This difference was also statistically significant.
The origin of high levels of sCD27 is not clear to researchers. They suspect two possible sources:
Further research is clearly needed to confirm and expand on the results of the UCLA study.
1.Franceschi S, Dal Maso L and La Vecchia C. Advances in the epidemiology of HIV-associated non-Hodgkin's lymphoma and other lymphoid neoplasms. International Journal of Cancer 1999;83(4):481-485.
2. Widney D, Gundapp G, Said JW, et al. Aberrant expression of CD27 and soluble CD27 (sCD27) in HIV infection and in AIDS-associated lymphoma. Clinical Immunology 1999;93(2):114-123.
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