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Penis and scrotum
Infectious disorders
Human immunodeficiency virus (HIV)
Reviewers: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)
Revised: 18 February 2010, last major update February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Etiology
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● Lack of circumcision confers up to 8x risk, apparently due to high lymphocyte density in foreskin mucosa (HIV-1 targets CCR5 and CXCR4 receptors on CD4+ T cells), higher than uterine ectocervix (Am J Path 2002;161:867, Am J Clin Pathol 2006;125:386)
● Factors favoring HIV infection via preputial surface include greater susceptibility of foreskin mucosa to trauma, longer survival of the virus in warm and moist subpreputial spaces, and lack of keratinization and high density of HIV target cells in the inner foreskin compared with the keratinized surface of the outer foreskin and glans (Nat Clin Pract Urol 2009:6:32)
● No infiltration by HIV-1 of foreskin outer surface
Clinical features
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● Circumcision recommended to reduce incidence in heterosexual men (J Infect Dev Ctries 2008;2:328, WHO)
● Most HIV-1 positive men are infected via the penis
Treatment
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● Highly active antiretroviral therapy (HAART)
Micro images
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High concentration of Langerhans cells (LC), Immunofluorescence staining for the HIV-1
T cells(CD4+) and macrophages (CD68+) co-receptors CCR5 and CXCR4 in adult
in foreskin male foreskin
Electron microscopy images
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Diagram HIV virus particles HIV budding from cultured lymphocyte
Additional references
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End of Penis and scrotum > Infectious disorders > Human immunodeficiency virus (HIV)
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