title: Relationship between HIV viral load and Langerhans cells of the cervical epithelium.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pathology, Mount Sinai Medical School, New York, USA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Levi
authors.forename: Joseph
authors.initials: J
authors.lastname: Feldman
authors.forename: Susan
authors.initials: S
authors.lastname: Holman
authors.forename: Afshin
authors.initials: A
authors.lastname: Salarieh
authors.forename: Howard D
authors.initials: HD
authors.lastname: Strickler
authors.forename: Shira
authors.initials: S
authors.lastname: Alter
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
mesh_terms: D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D002452:Cell Count; D002584:Cervix Uteri / Q000473:pathology*; D004279:DNA, Viral / Q000032:analysis; D004848:Epithelium / Q000473:pathology; D005260:Female; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000473:pathology* / Q000821:virology; D006679:HIV Seropositivity; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology*; D027383:Papillomaviridae / Q000235:genetics; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral