The Skin Immune System in the Course of HIV-1 Infection

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Abstract
In human immunodeficiency virus‐1 (HIV‐1) infection, diseases of the skin and mucous membranes frequently dominate the clinical picture as a consequence of progressive immunodeficiency. Functional impairment of the skin immune system, manifesting as a loss of the skin delayed‐type hypersensitivity response is very likely due to the infection of immunocompetent cells of the skin by HIV‐1. Besides CD4+ T cells, antigen‐presenting Langerhans cells have been established as major targets of HIV‐1 infection. The close physical contact of Langerhans cells with T lymphocytes during immune activation suggests a central role of these cells in the dissemination of HIV‐1 and the subsequent breakdown of the skin immune system. In addition, there are indications that mucosal Langerhans cells may represent prefered target cells for certain HIV‐1 subtypes and thereby facilitate mucocutaneous transmission of HIV‐1.