Lymphocyte Subsets in Cervicovaginal Lavage Specimens of HIV-Infected Women: A Surrogate Risk Marker of HPV-Associated Cervical Lesions

Abstract

<b><i>Introduction:</i></b> To better understand the role of mucosa immunity in the development of cervical carcinoma in HIV infection, cervical lymphocyte subsets were characterized in HIV+ and HIV− women, as well as their relation to HPV-associated cervical lesions. <b><i>Methods:</i></b> Eighty-three (52 HIV+, 31 HIV−) cell suspensions of cervicovaginal lavage (CVL) and 52 HIV+ peripheral blood (PB) samples were assessed by flow cytometry to evaluate lymphoid populations. High-risk (HR) HPV was assessed in liquid-based cytology and HIV mRNA in PB in the same patients. <b><i>Results:</i></b> Cervical CD4⁺ T cells and CD4⁺/CD8⁺ ratio were decreased (<i>p</i> &#x3c; 0.0001) and cervical CD8⁺ T cells were increased (<i>p</i> = 0.0080) in HIV+ women. These patients had lower CD4⁺ T-cell percentages in CVL compared to PB (<i>p</i> = 0.0257), and the opposite was true for CD8⁺ T cells (<i>p</i> = 0.0104). They also had a higher prevalence of high-grade squamous intraepithelial lesions (SILs) with an increased prevalence of HR HPV. Cervical CD8⁺ T cells were increased in HR HPV+ patients (<i>p</i> = 0.0300) and related to higher prevalence of SILs (<i>p</i> = 0.0001). <b><i>Discussion/Conclusion:</i></b> Cervical lymphoid populations can be characterized by flow cytometry, showing a distinct cervical T-cell compartment in HIV+ women. This may represent a surrogate risk marker of HPV-associated cervical lesions in this population and prompt further research on this subject, contributing to improving patients’ management.