Langerhans cell density and high-grade vulvar intraepithelial neoplasia in women with human immunodeficiency virus infection.
BACKGROUND
Decreased numbers of Langerhans cells (LCs) in the cervix of human immunodeficiency virus (HIV)-infected women are believed to contribute to the progression of human papilloma virus (HPV)-related squamous intraepithelial lesions. However, this impairment of local immunity has not been well studied in the vulva. The objective of this study was to compare the S100+ LC density in high-grade vulvar intraepithelial neoplasia (VIN) in HIV-positive and HIV-negative women.


METHODS
HIV-positive and HIV-negative patients with high-grade VIN, 48 (55%) and 40 (45%), respectively, were identified by retrospective chart review. Smoking status of patients was noted. The mean LC count per high-power field (HPF) was determined using S100 immunohistochemical staining. In situ hybridization was performed to detect HPV DNA types 16 and 18.


RESULTS
Mean S100+ LC counts for HIV-positive and HIV-negative patients were 5.82 and 9.86 per HPF, respectively (p = 0.0026). LC counts in HIV-positive and HIV-negative patients were compared between smoking and nonsmoking groups (HIV-positive p = 0.4812, HIV-negative p = 0.2821).


CONCLUSIONS
HIV-positive patients with high-grade VIN had significantly lower LC counts compared with HIV-negative patients. This suggests that local vulvar immunity as evaluated by S100+ LCs is impaired in HIV-positive women, possibly contributing to the progression of HPV-related vulvar lesions.
Taube
Janis M
JM
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. jtaube1@jhmi.edu
Nichols
Andrew D
AD
Bornman
Lynette S
LS
Bornman
Daniel M
DM
Jackson
Jay Brooks
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002278:Carcinoma in Situ / Q000276:immunology / Q000473:pathology* / Q000821:virology; D002452:Cell Count; D018450:Disease Progression; D005260:Female; D006678:HIV / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000276:immunology / Q000473:pathology*; D006801:Humans; D016867:Immunocompromised Host; D017403:In Situ Hybridization; D007801:Langerhans Cells / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D009418:S100 Proteins / Q000378:metabolism; D014846:Vulvar Neoplasms / Q000276:immunology / Q000473:pathology* / Q000821:virology
D014408:Biomarkers, Tumor; D009418:S100 Proteins