The aim of this study was to compare the local immune response in two groups of patients with high-grade cervical intraepithelial squamous lesions (SIL): one with HIV infection and the other with HPV infection alone.
Materials and methods
16 conization specimens (8 from HIV-infected and 8 from non-HIV-infected patients) of HPV-related, high-grade SIL were selected. The specimens from non-HIV patients were considered as controls. The total number of Langerhans cells, CD4 and CD8 cells present in 10 field areas (3.120 mm2) was recorded in each case. In HIV patients CD4 and CD8 peripheral counts were performed immediately before surgery.
Results
The CD4/CD8 ratio never exceeded 0.71, whereas the lowest ratio in controls was 0.81: this difference was statistically significant (P=0.0009). The mean number of Langerhans cells was markedly reduced in the high-grade SILs in the HIV patients in comparison with controls (P=0.001). The number of CD4 cells and the CD4/CD8 ratio correlated with the peripheral CD4 count (P=0.001 and 0.02).
Conclusions
In our study a marked local impairment of cervical immunoreactivity was observed, which may play a major role in the progression of these lesions in HIV-infected women.
BraunL.: Role of human immunodeficiency virus infection in the pathogenesis of human papilloma virus-associated cervical neoplasia.Am. J. Pathol., 144: 209–214, 1994.
2.
ContiM., AgarossiA., ParazziniF., MuggiascaM.L., BoschiniA., NegriE.: Human papillomavirus and human immunodeficiency virus infection and risk of cervical intraepithelial neoplasia in former intravenous drug abusers.Gynecol. Oncol.,49(3): 344–348, 1993.
3.
CordellJ.L., FaliniB., ErberW.N.: Immunoenzymatic labelling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal antialkaline phosphatase (APAAP complexes).J. Histochem. Cytochem., 32: 219–229, 1984.
4.
EllisP.S.J., WhiteheadR.: Mitosis counting - a need for reappraisal.Hum. Pathol., 12: 3–4, 1981.
5.
ElstonC.W., EllisI.O.: Pathological factors in breast cancer.1. The value of histological grade in breast cancer: experience from a large study with long term follow-up. Histopathology, 19: 403–410, 1991.
6.
FeingoldA.R., VermundS.H., BurkR.D., KelleyK.F., SchragerL.K., SchreiberK.: Cervical cytologic abnormalities and papilloma virus in women infected with human immunodeficiency virus.J. AIDS, 3: 896–903, 1990.
7.
GarzettiG.G., CiavattiniA., ButiniL., VecchiA., MontroniM.: Cervical displasia in HIV-seropositive women: role of human papillomavirus infection and immune status.Gynecol. Obstet. Invest.,40(1): 52–56, 1995.
8.
GervazE., Dauge-GeoffroyCh.M., SobhaniI., VissuzaineC.H., MignonM., BenhamouG.: Quantitative analysis of the immune cells in the anal mucosa.Pathol. Res. Pract., 191: 1067–1071, 1995.
9.
HawthornR.J.S., MurdochJ.B., MacLeanA.B., MacKieR.M.: Langerhans cells and subtypes of human papillomavirus in cervical intraepithelial neoplasia.Br. Med. J., 297: 643–646, 1988.
10.
HenryM.J., StanleyM.W., CruikshankS., CarsonL.: Association of human immunodeficiency virus-induced immunosuppression with human papilloma virus infection and cervical intraepithelial neoplasia.Am. J. Obstet. Gynecol., 160: 352–353, 1989.
11.
HussainL.A., LehnerT.: Comparative investigation of Langerhans cells and potential receptors for HIV in oral, genitourinary and rectal epithelia.Immunology, 85: 475–484, 1995.
12.
JohnsonJ.C., BurnettA.F., WilletG.D., YoungM.A., DonigerJ.: High frequency of latent and clinical human papilloma virus cervical infections in immunocompromised human immunodeficiency virus-infected women.Obstet. Gynecol., 79: 321–327, 1992.
13.
MacArdleJ.P., MullerK.: Quantitative assessment of Langerhans cells in human cervical intraepithelial neoplasia and wart virus infection.Am. J. Obstet. Gynecol., 154: 509–515, 1986.
14.
MaimanM., FruchterRG., GuyL.: A longitudinal study of human papilloma virus DNA detection in HIV-1 seropositive and seronegative women.Cancer, 71: 402–406, 1993.
15.
MaimanM., FruchterR.G., SerurE.: Recurrent cervical intraepithelial neoplasia in human immunodeficiency - seropositive women.Obstet. Gynecol., 82: 170–174, 1993.
16.
MaimanM., FruchterR.G., SerurE., RemyJ.C., FeuerG., BoyceJ.: Human immunodeficiency virus infection and cervical neoplasia.Gynecol. Oncol., 38: 377–382, 1990.
17.
MatorrasB., AricetaJM., RementeriaA., CorralJ., Gutierrez de TeranG., DiezJ.: Human immunodeficiency virus-induced immunosuppression: a risk factor for human papilloma virus infection.Am. J. Ostet. Gynecol., 164: 42–44, 1991.
18.
RosiniS., CaltagironeS., TalliniG., LattanzioG., Demopou-losR., PiantelliM., MusianiP.: Depletion of stromal and intraepithelial antigen-presenting cells in cervical neoplasia in human immunodeficiency virus infection.Hum. Pathol., 27: 834–838, 1996.
19.
SchaferA., FriedmannW., MielkeM., SchwartlanderB., KochM.A.: The increased frequency of cervical displasia-neoplasia in women infected with human immunodeficiency virus is related with degree of immunosuppression.Am. J. Obstet. Gynecol., 164: 593–599, 1991.
20.
SimonsenJ.N., CameronD.W., GakinyaM.N.: Human immunodeficiency virus infection among men with sexually transmitted disease: experience from a center in Africa.N. Engl. J. Med., 319: 274–278, 1988.
21.
SpinilloA., TentiP., ZappatoreR., BarbariniG., MaccabruniA., CarrattaL.: Prevalence, diagnosis and treatment of lower genital neoplasia in women with human immunodeficiency virus infection.Eur. J. Obstet. Gynecol. Reprod. Biol., 43: 235–241, 1992.
22.
SpinilloA., TentiP., ZappatoreR., De SetaF., SiliniE., GuaschinoS.: Langerhans cell counts and cervical intraepithelial neoplasia in women with human immunodeficiency virus infection.Gynecol. Oncol., 48: 210–213, 1993.
23.
TayS.K., JenkinsD., MaddoxP., HoggN., SingerA.: Tissue macrophage response in human papillomavirus infection and cervical intraepithelial neoplasia.Br. J. Obstet. Gynecol., 94: 1094–1097, 1987.
24.
TayS.K., JenkinsD., MaddoxP., SingerA.: Lymphocyte phenotypes in cervical intraepithelial neoplasia and human papillomavirus infection.Br. J. Obstet. Gynecol., 94: 16–21, 1987.
25.
TayS.K., JenkinsD., SingerA.: Natural killer cells in cervical intraepithelial neoplasia and human papillomavirus infection.Br. J. Obstet. Gynecol., 94: 901–906, 1987.
26.
VermundS.H., KelleyK.F., KleinR.S., FeingoldA.R., SchreiberK., MunkG.: High risk of human papillomavirus infection and cervical squamous intraepithelial lesions among women with symptomatic human immunodeficiency virus infection.Am. J. Obstet. Gynecol., 165: 392–400, 1991.
