HIV-INFECTED LANGERHANS CELLS CONSTITUTE A SIGNIFICANT PROPORTION OF THE EPIDERMAL LANGERHANS CELL-POPULATION THROUGHOUT THE COURSE OF HIV DISEASE

Human immunodeficiency virus (HIV) is known to infect Langerhans cells , but controversy still exists about the occurrence of HIV-infected La ngerhans cells in the skin of HIV-infected individuals and about the d ensity of epidermal Langerhans cells during the course of HIV disease. In this study, epidermal Langerhans cell population densities were an alyzed quantitatively in serial biopsies from two burn patients acquir ed over an 11-y period following infection with HIV from transfusions received during their acute treatment, At each biopsy time point, the density of epidermal Langerhans cells and the proportion that were inf ected with HIV were analyzed by immunostaining. In both patients, skin grafts were slow to repopulate with Langerhans cells and did not atta in normal Langerhans cell densities until about 2 y after grafting, Th ereafter, Langerhans cell densities remained within normal limits with the exception of six biopsies at random times that showed a supernorm al number of epidermal Langerhans cells. HIV-infected Langerhans cells were first detected at about 2 y post-infection and comprised about o ne-third of the Langerhans cell population, At subsequent times, HIV p 24-stained Langerhans cells were identified in most biopsies and typic ally constituted about one third to one half of the total Langerhans c ell population, The findings show that HIV-bearing Langerhans cells co nstitute a significant proportion of the epidermal Langerhans cell pop ulation over long periods of asymptomatic disease but are unevenly dis tributed throughout the skin. Normal population densities of epidermal Langerhans cells are maintained for years, although transient increas es may occur randomly.