Placental villous lesions in HIV-1 infection treated with zidovudine
Castejón, O.C.; López, A.J.; Pérez Ybarra, L.M.; Castejón, O.C.
Ginecologia y Obstetricia de Mexico 79(5): 269-279
2011
ISSN/ISBN: 0300-9041 PMID: 21966815 Document Number: 652129
HIV-1 reaches the placenta through the maternal-fetal transmission from an infected uterus. This virus has cytolytic capabilities. The placenta in its maturation process has regressive or degenerative changes within certain limits, are considered normal. However, factors such as virus and antiretrovirals, can increase the proportion of these lesions. To evaluate morphological changes in placental villi of pregnant women infected with HIV-1 treated with AZT. descriptive, prospective, comparative, with non-probability sampling of observations in villi as units of analysis of the placentas from the group of patients with HIV-1 infection and zidovudine regimen and of the control group of four placentas from HIV negative patients. Both groups in the last trimester of pregnancy. H-E staining was used in 25 films from five placental regions of the study group and four from the control group, using a protocol of 6 variables identifying syncytial knots, fibrinoid changes, villous edema, stromal fibrosis, calcification and villous immaturity. Observations were analyzed using ANOVA as a 2 x 5 factorial arrangement with 4 replications subsampling and split plot design and Tukey test. Chorionic villi showed percentages of alterations that exceed the normal range. It showed significant differences (p<0.05) between the placentas exposed to HIV-1 and AZT and normal placentas in relation to the percentage of villi affected by 5 variables, except fibrosis. The lesions may be increasing the vertical transmission of HIV-1. We also found evidence that the placenta is not in the best conditions for the transfer of gases, nutrients and metabolites, which could promote a decrease in birth weight and placental weight.