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Published on: August 31, 2014
Relationship between HIV viral load and Langerhans cells of the cervical epithelium
Gabriel Levi1, Joseph Feldman, Susan Holman
1Department of Pathology, Mount Sinai Medical School, New York, USA.
Insights
Cervical Langerhans cell density decreases with detectable HIV RNA, indicating a weakened mucosal immune response. High-grade cervical lesions may be linked to a heightened local immune response, despite HPV presence.
Area of Science:
- Immunology
- Gynecology
- Infectious Diseases
Background:
- Cervical Langerhans cells play a crucial role in mucosal immunity.
- HIV infection can impact immune responses in the female genital tract.
- Cervical intraepithelial lesions are often associated with human papillomavirus (HPV) infection.
Purpose of the Study:
- To investigate the relationship between cervical Langerhans cell density, cervical histology, and HIV viral load.
- To explore associations with HPV-DNA detection, CD4 counts, and smoking status.
Main Methods:
- Cervical biopsies from 84 HIV-infected and 17 high-risk women were analyzed.
- Langerhans cells were quantified using S-100 immunohistochemistry.
- HIV RNA levels, HPV-DNA, and T-cell subsets were assessed using molecular and flow cytometry techniques.
Main Results:
- A significant decrease in Langerhans cell density was observed in HIV-infected women with detectable HIV RNA (P = 0.01).
- Increased Langerhans cell density correlated with high-grade squamous intraepithelial lesions (P = 0.05).
- HPV-DNA, smoking status, and CD4 counts were not significantly associated with Langerhans cell density.
Conclusions:
- Detectable HIV RNA is associated with reduced cervical Langerhans cell density, suggesting impaired mucosal immunity.
- High-grade cervical dysplasia may indicate an enhanced local immune response to HPV infection.
Aim:
To determine the relationship between the density of cervical mucosa Langerhans cells, cervical histology, and HIV viral load.
Methods:
Eighty-four HIV-infected and 17 women at high risk for HIV had cervical biopsies assessed for squamous intraepithelial lesions and Langerhans cell density. Langerhans cells were identified using the S-100 immunohistochemical stain and were counted manually. Polymerase chain reaction assays were used to detect cervical human papillomavirus (HPV)-DNA. T-cell subsets were determined using immunofluorescent flow cytometry. Plasma HIV RNA levels were measured using a nucleic acid sequence-based amplification technique. The associations between cervical Langerhans cell density, cervical histology, CD4 counts, HIV viral loads, HPV-DNA detection, and smoking status were assessed using multivariate statistical models.
Results:
In multivariate analysis among women infected with HIV, the mean Langerhans cell density per high-powered field was 4.00 among women with no detectable plasma HIV-RNA, and 1.92 among those with detectable HIV-RNA (P = 0.01). The mean cervical Langerhans cell density was increased in women with high-grade squamous intraepithelial lesions compared with those with low-grade squamous intraepithelial lesions and normal/metaplastic histology (3.87 vs 2.11; P = 0.05). Neither HPV-DNA detection, smoking status, nor CD4 count was significantly associated with Langerhans cell density.
Conclusions:
The decrease in cervical Langerhans cell density in women with detectable HIV-RNA suggests an impaired mucosal immune response to local infections, such as HPV. Conversely, HPV infection resulting in high-grade dysplasia might be associated with an enhanced local immune response.
