Department of Anatomic Pathology, Hospital Garcia de Orta, Av. Prof Torrado da Silva, 2801-951, Almada, Portugal.
Department of Gynecology, Hospital Garcia de Orta, Av. Prof Torrado da Silva, 2801-951, Almada, Portugal.
Int J Infect Dis. 2021 Feb;103:370-377. doi: 10.1016/j.ijid.2020.10.083. Epub 2020 Nov 3.
This study aimed to analyse cervical lymphocytic populations in HIV+ and HIV- patients and correlate different cervical lesions with HIV viral load and presence of high-risk HPV types.
A total of 132 histological specimens from 40 HIV+ and 72 HIV- patients were evaluated for CD4 and CD8 T cell distribution, presence of high-risk HPV types, peripheral blood HIV viral load and CD4/CD8 ratio.
High-grade squamous intraepithelial lesions (HSIL) and squamous cell carcinoma (SCC) from HIV+ patients had lower CD4 T cell scores compared with HIV- patients. In all lesion groups, HIV+ patients presented higher epithelial and stromal CD8 T cell scores. HIV viral load was more often detectable in patients with SCC than in those with low-grade squamous intraepithelial lesion (LSIL) (p = 0.0409). HSIL HIV+ patients had lower circulating CD4 T cell counts (p = 0.0434) and CD4/CD8 ratio (p = 0.0378) compared with LSIL HIV+ patients. High-risk HPV types other than 16 and 18/45 were more prevalent in the HIV+ group.
These results support an imbalance between cervical CD4 and CD8 T lymphocytes of HIV+ patients with SIL and SCC, with increased CD8+ infiltrate density with lesion severity, even in patients with immune system recovery under cART.
本研究旨在分析 HIV+和 HIV-患者的宫颈淋巴细胞群,并将不同的宫颈病变与 HIV 病毒载量和高危 HPV 类型的存在相关联。
共评估了 40 名 HIV+和 72 名 HIV-患者的 132 个组织学标本,以评估 CD4 和 CD8 T 细胞分布、高危 HPV 类型、外周血 HIV 病毒载量和 CD4/CD8 比值。
与 HIV-患者相比,HIV+患者的高级别鳞状上皮内病变(HSIL)和鳞状细胞癌(SCC)的 CD4 T 细胞评分较低。在所有病变组中,HIV+患者的上皮和基质 CD8 T 细胞评分均较高。与低级别鳞状上皮内病变(LSIL)相比,SCC 患者的 HIV 病毒载量更易检测到(p=0.0409)。与 LSIL HIV+患者相比,HSIL HIV+患者的循环 CD4 T 细胞计数(p=0.0434)和 CD4/CD8 比值(p=0.0378)较低。除 16 和 18/45 以外的高危 HPV 类型在 HIV+组中更为常见。
这些结果支持 HIV+患者的 SIL 和 SCC 中宫颈 CD4 和 CD8 T 淋巴细胞失衡,即使在接受 cART 后免疫系统恢复的患者中,CD8+浸润密度也随病变严重程度增加。