Johnstone F D, Williams A R, Bird G A, Bjornsson S
Department of Obstetrics and Gynaecology, Edinburgh University, Scotland.
Obstet Gynecol. 1994 Apr;83(4):586-93. doi: 10.1097/00006250-199404000-00017.
To determine whether lymphocytic infiltration of the endometrium accompanies human immunodeficiency virus (HIV) infection.
Endometrial samples from 12 HIV-infected women and from rigorously matched controls were examined. The following markers were used: common leukocyte antigen (CD45), T lymphocytes (CD3), monocytes-macrophages (CD68), and CD4 and CD8 lymphocytes. Cell counts were performed without knowledge of HIV status. Factors considered in relation to these markers were menstrual symptoms, pelvic pain, peripheral blood CD4+ count, and time since seroconversion.
Histology showed conventional features of chronic endometritis in only one case. In the remainder, the endometrium of HIV-infected women, compared with controls, showed an increase in CD45 cells (P < .02) and an increase in CD3 staining cells (P < .05). This appeared to be restricted to those with menstrual symptoms, and this group also had lower peripheral blood CD4 counts. There was no difference in cells of the monocyte-macrophage series (CD68). In contrast to control samples, CD4 lymphocytes were infrequent or absent in the endometrium of HIV-infected women, regardless of peripheral blood CD4 count or presence of menstrual symptoms; however, this was not universal, as one sample showed an area of dense CD4 cell infiltration. The ratio of CD4 to CD8 was reduced in HIV-seropositive samples compared with controls (P < .02).
We hypothesize that chronic endometritis of a nonclassical form may be common in advancing HIV disease, possibly directed against HIV-infected cells or self-determined antigens. This could be associated with morbidity and may represent a reservoir of infection. Endometrial depletion of CD4 cells is a common, but not universal, feature and may be independent of immune compromise.
确定子宫内膜淋巴细胞浸润是否伴随人类免疫缺陷病毒（HIV）感染。
对12名HIV感染女性及严格匹配的对照者的子宫内膜样本进行检查。使用了以下标志物：共同白细胞抗原（CD45）、T淋巴细胞（CD3）、单核细胞-巨噬细胞（CD68）以及CD4和CD8淋巴细胞。在不知晓HIV感染状态的情况下进行细胞计数。与这些标志物相关的因素包括月经症状、盆腔疼痛、外周血CD4⁺计数以及血清转化后的时间。
组织学检查仅在1例中显示出慢性子宫内膜炎的典型特征。在其余病例中，与对照组相比，HIV感染女性的子宫内膜CD45细胞增加（P < 0.02），CD3染色细胞增加（P < 0.05）。这似乎仅限于有月经症状的患者，且该组外周血CD4计数也较低。单核细胞-巨噬细胞系列（CD68）的细胞无差异。与对照样本相比，无论外周血CD4计数或月经症状如何，HIV感染女性的子宫内膜中CD4淋巴细胞稀少或缺失；然而，并非普遍如此，因为有一个样本显示有密集的CD4细胞浸润区域。与对照组相比，HIV血清阳性样本中CD4与CD8的比例降低（P < 0.02）。
我们推测，非典型形式的慢性子宫内膜炎在进展性HIV疾病中可能常见，可能针对HIV感染细胞或自身抗原。这可能与发病相关，并且可能代表一个感染源。子宫内膜CD4细胞减少是一个常见但非普遍的特征，可能与免疫受损无关。
