Langerhans Cell Density in Cervical Intraepithelial Neoplasia Associated With Human Papillomavirus Infection in HIV-Infected and HIV-Noninfected Brazilian Women

Abstract

Human immunodeficiency virus infection was found to be an independent factor that explains the decrease in local immunity in the uterine cervix, which could allow the development of cervical lesions. This effect was not associated with CD4 lymphocyte count or HIV viral load.

Different methods of cell quantification can lead to different results: a comparison of digital methods using a pilot study of dendritic cells in HIV-positive patients

“…This can be explained by the limited sample size effect. Regarding the specific patient group evaluated in the present study, some authors (19,20) have suggested that HIV infection may be an independent factor, decreasing the density of LCs even in patients with normal CD4+ T cell counts and undetectable viral load. In view of these findings, it is possible that the development of neoplasias and opportunistic infections in HIV-positive patients may be related to HIV infection even with the apparent immunological reestablishment achieved by the success of modern antiretroviral therapies.…”

“…However, the authors believe that following the methodology presented and discussed above, the reliability and reproducibility of the DCs quantification will significantly improve. There is a heterogeneity of the quantification methods presented in the literature, including the studies that evaluate the density of DCs (19,(22)(23)(24)(25)(27)(28)(29). Since we have shown that the quantification method can affect the research results and may lead to the acceptance or not of their significance, the necessity of a cell counting methodology with higher reliability is enforced.…”

“…Furthermore, LCs migration inhibition caused by tumor-derived factors prevents LCs from promoting antitumoral immunity (15)(16)(17). Previous studies have shown the low density of LCs in squamous cell carcinoma (SCC) of the skin (18), uterine cervix (19), and anal mucosa (20). Although the relationship among CD4+ T (T helper cells) cell counts, HIV viral load, and LCs density remains unclear (21), these studies suggest that immunological changes associated with HIV infection are predisposing factors to the development of SCC.…”

“…Once there are no studies that investigate DCs in HNC in HIV-positive patients, the quantification of these cells is prime for a better understanding of this subject and may reveal important data for future steps. However, a great variability of values has been noticed in studies investigating the density of DCs (19,(22)(23)(24)(25), which complicate the use of published data as reference for new studies.…”