CD4+ and CD8+ cell populations in HIV-positive women with cervical squamous intra-epithelial lesions and squamous cell carcinoma

Int J Infect Dis. 2021 Feb:103:370-377. doi: 10.1016/j.ijid.2020.10.083. Epub 2020 Nov 3.

Abstract

Introduction: 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.

Material and methods: 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.

Results: 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.

Discussion: 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.

Keywords: CD4(+) T cell; CD8(+) T cell; Carcinoma; Cervix; HIV; Viral load.

MeSH terms

  • Adult
  • CD4-Positive T-Lymphocytes / physiology*
  • CD8-Positive T-Lymphocytes / physiology*
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / immunology*
  • Carcinoma, Squamous Cell / virology
  • Female
  • HIV Infections / complications*
  • Humans
  • Middle Aged
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / virology
  • Uterine Cervical Dysplasia / complications
  • Uterine Cervical Dysplasia / immunology*
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / complications
  • Uterine Cervical Neoplasms / immunology*
  • Uterine Cervical Neoplasms / virology
  • Viral Load