Uncircumcised men may be more likely to become infected with HIV because the cells on the inside of the foreskin are more susceptible to HIV, according to US research published in the September issue of the American Journal of Pathology.
Numerous studies have reported that uncircumcised men have higher rates of HIV infection and are at a two to eightfold increased risk of becoming infected with HIV compared to circumcised men.
Investigators examined the foreskin tissue from eight children and six adults. This was compared to cervical tissue. The investigators found that the cells under the foreskin contain higher concentrations of CD4+ T cells and other cells including macrophages and Langerhans’ cells which are specifically targeted by HIV, than tissue from the cervix. In addition, the cells targeted by HIV were found in the greatest densities in the foreskin tissue of men with a history of sexually transmitted infections (STIs), a finding consistent with studies which suggest that men with STIs are more vulnerable to HIV.
When the tissue cultures from both the foreskin and cervix was exposed to HIV, the CD4+ T cells and other cells from the foreskin were infiltrated by HIV much more rapidly than the cervical cells.
Dr Bruce Patterson, a viral pathologist, said the keratin layer found on the inner mucosal surface of the foreskin predisposed uncircumcised men to HIV infection.
The study’s lead investigator Dr Robert Bailey of the University of Illinois has begun a four year study to compare rates of HIV acquisition in 1,400 circumcised African males compared to 1,400 uncircumcised men.
Patterson B et al. Susceptibility to Human Immunodeficiency Virus-1 infection of human foreskin and cervical tissue grown in explant culture. 161: 867-873, 2002