D'costa Grace Francis, Khadke Kavita, Patil Yoganand Vishwasrao
Department of Pathology, Grant Medical College, Byculla, Mumbai.
Indian J Pathol Microbiol. 2007 Jul;50(3):515-9.
The spectrum of HIV pathological lesions encountered in the placenta has not been well documented in the literature. To address this issue, we examined 51 placentae of HIV positive mothers, prospectively over a one year period and compared the pathology of the cases treated with zidovudine (AZT) or nevirapine (NVP) with untreated cases. We also correlated the placental pathology with the HIV status of the neonates. The maternal to child transmission rate was 4.44%. A lower fetal / placental weight ratio was seen in normal birth weight neonates compared to low birth weight neonates. No significant gross lesions were encountered and the placental disc did not show any significant decrease in dimensions. The commonest inflammatory lesion seen was chorio-amnionitis 31.37% and the commonest non-inflammatory lesion was cytotrophoblastic hyperplasia 76.47%. There was no significant decrease in the incidence of the lesions following anti-retroviral therapy in our study, and we did not find any correlation between the incidence of placental lesions and the HIV status of the newborn.
胎盘出现的HIV病理损害范围在文献中尚无充分记载。为解决这一问题，我们前瞻性地在一年时间里检查了51例HIV阳性母亲的胎盘，并将接受齐多夫定（AZT）或奈韦拉平（NVP）治疗的病例的病理情况与未治疗病例进行了比较。我们还将胎盘病理情况与新生儿的HIV状况进行了关联分析。母婴传播率为4.44%。与低出生体重新生儿相比，正常出生体重新生儿的胎儿/胎盘重量比更低。未发现明显的大体病变，胎盘盘状结构尺寸也未出现任何显著减小。最常见的炎性病变是绒毛膜羊膜炎（31.37%），最常见的非炎性病变是细胞滋养层细胞增生（76.47%）。在我们的研究中，抗逆转录病毒治疗后病变发生率没有显著下降，并且我们未发现胎盘病变发生率与新生儿HIV状况之间存在任何关联。
