Abstract
BackgroundThe aim of this study was to compare histomorphometric changes and the results of immunohistochemical tests for VCAM, ICAM-1, CD4 and CD8 in normal placentas from HIV-seropositive pregnant women.MethodsSamples of normal placentas were divided into 2 groups: healthy HIV-seronegative pregnant women (control group = C = 60) and HIV-seropositive women (experimental group = E = 57). Conventional histological sections were submitted to morphometric analysis and evaluated in terms of the immunohistochemical expression of ICAM-1, VCAM, CD4 and CD8.ResultsThe villi in group E were smaller than those in group C. The median for the CD8+ T cell count was higher in group E than in group C (p = 0.03). Immunohistochemical expression of ICAM-1 was observed in 57% of the cases in group E, compared with 21% of those in group C (p = 0.001). There was no difference in VCAM expression or CD4+ cell counts between groups and no correlation between the data for antiretroviral therapy and morphometric or immunohistochemical data.ConclusionsThe morphometric data showed that placentas of HIV-seropositive pregnant women tend to have smaller villi than those of seronegative women. In addition, immunohistochemical testing for infectious agents helped to identify cases that were positive for microorganisms (6/112) that routine pathological examination had failed to detect. The anti-p24 antibody had a limited ability to detect HIV viral protein in this study (2/57). Correlation of immunohistochemical expression of CD8+ T cells and ICAM-1 with the presence of HIV in the placenta revealed that those expressions can act as biomarkers of inflammatory changes. There was no correlation between the data for antiretroviral therapy and morphometric or immunohistochemical data.
Highlights
Vertical transmission of human immunodeficiency virus (HIV) is the main route of HIV infection in children
Morphometric analysis showed that there were significant differences between the areas and perimeters of the villi in placentas from HIV-seropositive women and the corresponding areas and perimeters for HIV-seronegative women, the mean values for the latter group being higher (Table 2). These results suggest that the villi in placentas from the HIV-seronegative group may be larger than those from the HIV-seropositive group
Our results showed that the viral loads did not affect expression of ICAM-1, CD8+ T-cell concentrations or the area or perimeter of the placental villi
Summary
Vertical transmission of HIV is the main route of HIV infection in children. In Brazil this route is responsible for more than 80% of HIV cases in children under 13 years of age and for almost all cases currently diagnosed in this age group. By June 2004, a total of 9162 cases of vertically transmitted HIV had been reported in Brazil, or 2.5% of all AIDS cases reported in this country[1]. The placenta acts as a barrier to vertical transmission, trophoblasts can become infected through cell-to-cell transmission during this first phase because they are in close contact with maternal blood vessels[2]. The first contact between trophoblast and decidual cells, and with maternal blood, occurs during the first trimester. The aim of this study was to compare histomorphometric changes and the results of immunohistochemical tests for VCAM, ICAM-1, CD4 and CD8 in normal placentas from HIV-seropositive pregnant women
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