Lymphoid follicles are generated in high-grade cervical dysplasia and have differing characteristics depending on HIV status

Akiko Kobayashi, Teresa Darragh, Brian Herndier, Kathryn Anastos, Howard Minkoff, Mardge Cohen, Mary Young, Alexandra Levine, Linda Ahdieh Grant, William Hyun, Vivian Weinberg, Ruth Greenblatt, Karen Smith-McCune

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


The exact role of the mucosal immune response in the pathogenesis of human papillomavirus (HPV)-related premalignant and malignant diseases of the genital tract is poorly understood. We used immunohistochemical analysis to characterize immune cells in normal cervix (N = 21), HIV-negative high-grade dysplasia (N = 21), and HIV-positive high-grade dysplasia (N = 30). Classical germinal centers were present in 4.7% of normal cervix, 33% of high-grade lesions from HIV-negative women, and 3.3% of high-grade lesions from HIV-positive women (P = 0.003). HPV16 E7 antigen was detected in a subset of germinal centers, indicating that the secondary immune response was directed in part against HPV. Lymphoid follicles were present in 9.5% of normal cervix, 57% of HIV-negative high-grade dysplasia, and 50% of HIV-positive high-grade dysplasia (P = 0.001 normal versus high-grade). A novel type of lymphoid aggregate, consisting predominantly of CD8+ T cells, was detected in 4.8% of normal cervix, 0% of HIV-negative high-grade dysplasia, and 40% of HIV-positive high-grade dysplasia (P < 0.001). The recurrence rate of high-grade dysplasia within one year was significantly higher in women with such CD8+ T cell-dominant aggregates (P = 0.02). In summary, the types of lymphoid follicle in lesions from HIV-positive women were significantly different from those from HIV-negative women, and these differences are associated with the worse clinical outcome in HIV-positive women.

Original languageEnglish (US)
Pages (from-to)151-164
Number of pages14
JournalAmerican Journal of Pathology
Issue number1
StatePublished - 2002
Externally publishedYes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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