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The World in Medicine
JAMA. 2006;296(7):759. doi: 10.1001/jama.296.7.759-b

HIV and Circumcision

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Australian researchers have discovered that HIV-susceptible Langerhans cells on the inner surface of the foreskin and frenulum of uncircumcised men are poorly protected by a thin layer of keratin, a finding that may help explain why removal of this tissue during circumcision appears to reduce female-to-male transmission of HIV (McCoombe SG and Short RV. AIDS. 2006;20:1491-1495). Scientists suspect that the HIV receptor–bearing Langerhans cells in mucosal surfaces targeted by HIV serve as a primary point of viral entry following sexual exposure.

The researchers obtained foreskins from healthy adult men undergoing elective circumcision and uncircumcised penises from cadavers. They found that cells with HIV receptors were present in all penile epithelia, but Langerhans cells were closest to the surface of the skin in the inner foreskin and frenulum. They also found that the inner foreskin had a significantly thinner keratin layer than the outer foreskin or glans penis.

“These findings …

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