Guimarães Janaína Valadares, Salge Ana Karina Marques, Penha Daniel Silva Gontijo, Murta Eddie Fernando Cândido, Saldanha João Carlos, Castro Eumenia Costa da Cunha, Dos Reis Marlene Antônia, Teixeira Vicente de Paula Antunes
Tropical Pathology and Public Health Institute, Federal University of Goiàs, 74605-050 Goiânia, Brazil.
Ann Diagn Pathol. 2007 Aug;11(4):258-61. doi: 10.1016/j.anndiagpath.2006.09.004.
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.
在巴西乃至全球，已有多种影响子宫颈的一般病理过程被描述。本研究的目的是对艾滋病尸检患者的子宫颈上皮进行形态学评估。这是一项对1993年至2003年期间38名女性尸体解剖的子宫颈进行的横断面研究。我们评估了年龄在20至40岁之间的女性子宫颈，其中20名患有艾滋病（52.63%），18名未患艾滋病（47.37%）。在艾滋病患者中发现的炎性浸润更为明显，且主要由单核细胞组成，这是慢性炎症的特征。此外，这些患者中坏死、纤维化和化生也更为常见。艾滋病患者的子宫颈上皮明显更薄。这种萎缩是由于细胞数量和表面积显著减少所致（P < 0.01）。上皮厚度与艾滋病患者的营养状况之间仍存在显著相关性。影响艾滋病患者子宫颈的一般病理过程，尤其是萎缩，可能会促进其他病原体的侵入。我们建议对这些患者的营养状况和抗逆转录病毒治疗的依从性进行常规评估，并鼓励即使在HIV阳性伴侣之间也使用避孕套，以防止病毒载量可能增加以及再次感染，从而导致病情加重。
