Morphometric peculiarities of the cervix uteri in immunodeficiency states

Abstract

Enhancing each other’s effects – HIV infection and the changes caused by alcohol abuse, trigger a chain of pathological reactions that sometimes lead to reversible and often irreversible pathological processes in the cervix uteri (CU). Local and general decrease in immunoresistance invariably leads to disturbance of physiological CU microbiome. Given all the above, the aim of our work was to identify pathological changes in CU that occur in HIV-infected women on the background of chronic alcoholism. Section material of 110 women of reproductive age from 20 to 40 years, which were divided into four groups, was studied. After the manufacture of micropreparations, a morphometric study was performed. Significant pathological changes in CU were revealed in HIV-infected women suffering from alcoholism. The maximum thickness of nonkeratinized stratified squamous epithelium (734.23±61.33 x10^-6m) was characteristic of a group of HIV-infected women suffering from chronic alcoholism. In HIV-infected women, this figure is 3.14% lower and is 711.21±59.28 x10^-6m. In women suffering from alcoholism without concomitant HIV infection, this figure is 697.8±47.88 x10^-6m, which is 5% less than in the group with combined pathology. As expected, the lowest value was in the comparison group, where it was 527.23±44.37 x10^-6m. There was a significant difference between the comparison group of HIV-infected women with alcoholism and the control group, which is 28.2%. In the studied material of HIV-infected patients, a high degree of distribution of the severity of cervical dysplasia was determined – 9.1%. Moderate and low degree, respectively, 19.42 and 37.12% in this group of subjects. When studying the degree of infiltration of the lamina propria mucosa in the study groups, it was found that the largest number of cases of severe infiltration (44.5%) was found in the group suffering from chronic alcoholism, and in the HIV groups no such case was detected. On the basis of the conducted research it is possible to assume the combined influence of the factors promoting development of pathological processes both in an epithelium, and in a mucous membrane of CU. Thus, HIV infection and alcohol abuse can exacerbate each other’s pathological effects and lead to pronounced pathomorphological changes in CU, namely: thickening of the mucosal epithelium due to frequent development of various types of warts, mucosal dysplasia and even severe cellular infiltration of the mucous membrane.