Thickness of the cervical epithelium of autopsied patients with acquired immunodeficiency syndrome.

Several general pathologic processes that affect the uterine cervix have been described in Brazil and in the world. The aim of the current study was to evaluate morphometrically the cervical epithelium of autopsied patients with AIDS. This is a cross-sectional study of the cervix of 38 women autopsied from 1993 to 2003. We evaluated the cervix of women aged 20 to 40 years, 20 with AIDS (52.63%) and 18 without (47.37%). The inflammatory infiltrate found in the AIDS patients was more accentuated and predominantly composed of monocytes, which is characteristic of chronic inflammation. In addition, necrosis, fibrosis, and metaplasia were also more frequent in these patients. The cervical epithelium was considerably thinner in the AIDS patients. This hypotrophy occurred because of a significantly accentuated reduction in the number and surface area of cells (P < .01). There was still a significant correlation between the thickness of the epithelium and the nutritional status of AIDS patients. General pathologic processes, which affect the cervices of patients with AIDS, especially hypotrophy, could facilitate the penetration of other infectious agents. We suggest that the nutritional status of these patients and the adherence to antiretroviral therapy be routinely evaluated and the use of condoms stimulated even between HIV-positive partners to prevent possible increases in the viral load and reinfections that contribute to the aggravation of the disease.