Condylomata acuminata (anogenital warts) contain accumulations of HIV-1 target cells that may provide portals for HIV transmission

Background: Condylomata acuminata [anogenital warts (AGW)] are prevalent in HIV-infected individuals and sexually active populations at risk for HIV acquisition, and have been associated with HIV transmission. We compared AGW to control tissue for abundance, types and location of HIV-target cells, and for susceptibility to HIV infection in vitro, to provide biological evidence that AGW facilitate HIV transmission. Methods: We used immunohistology to identify HIV-target cells in AGW and control skin. We also inoculated AGW and control tissue from HIV-negative men with HIV in vitro, and assessed infection by TZM-bl and p24 assays. Results: CD1a+ dendritic cells, CD4+ T cells and macrophages were significantly more abundant in the epidermis of AGW than control tissue. These HIV target cells also often appeared in large focal accumulations in the dermis of AGW. Two out of 8 AGW vs. 0 of 8 control tissues showed robust infection with HIV in vitro. Conclusions: Compared to normal skin, AGW contain significantly higher concentrations of HIV-target cells that may be susceptible to HIV infection. Condylomata may thus promote HIV transmission, especially in the setting of typical lesion vascularity and friability. Prevention or treatment of AGW may decrease the sexual transmission of HIV