Reduced number of Langerhans cells in oesophageal mucosa from AIDS patients

Aims: The oesophageal mucosa is a frequent target of opportunistic infectio ns in human immunodeficiency virus (HIV) infection. Langerhans cells (LC) a re known as a target and reservoir of HIV in the skin. The aim of this stud y was to characterize oesophageal LC in HIV-infected patients. Methods and results: Thirty oesophageal biopsies were obtained from 29 pati ents (median age 35.5), all in stage TV of the HIV Center of Disease Contro l Classification. We performed histological assessment of the oesophageal m ucosa and immunohistochemical detection of oesophageal LC using an anti-CD1 a antibody, followed by morphometric analysis. Biopsies from 17 noninfected patients were studied using the same procedure. LC in oesophageal mucosa o f the HIV positive patients showed a significantly and dramatically decreas ed number (LC(N) median 5.85/mm(2)) and surface/epithelial surface (LC (S) ratio = 0.09) when compared with HIV-negative controls (LC(N) median 29.7/m m(2), LC(S) ratio = 1.83) with P = 0.003 for LC(N) and P < 0.0001 for LC(S) . Conclusion: These data suggest that oesophageal LC are, like their epiderma l counterparts, a preferential target for HIV infection. Their alterations may provide a clue to the pathogenesis of the decreased local oesophageal i mmunity and to the occurrence of opportunistic infections.