Infectious disease immunohistochemistry in placentas from HIV-positive and HIV-negative patients.
Studies comparing placental pathology between human immunodeficiency virus (HIV)-positive and HIV-negative patients have shown conflicting results. In addition, few studies have evaluated the infectious etiology of placental inflammation in HIV-positive patients. We examined a cohort of placentas from 73 HIV-positive and 41 HIV-negative patients to gain a better understanding of the spectrum of placental inflammatory lesions. Bacterial and viral immunohistochemistry (IHC) was run on a subset of placentas (12 HIV-positive and 7 HIV-negative) with the greatest amount of inflammation. Although few histologic differences were seen between the HIV-positive and HIV-negative groups, chorioamnionitis was of a higher stage in the HIV-positive placentas. An infectious agent was found by IHC in 3 of 7 HIV-negative patients (2 Neisseria spp. and 1 group B Streptococcus ). One HIV-positive placenta showed gram-positive cocci on fetal membranes; organisms were not detected by IHC. In 2 patients, the etiologic agent was not suspected prior to IHC. This study identified that acute inflammation is less common in placentas from HIV-positive patients, compared with HIV-negative patients. However, when severe inflammation is present, infectious organisms may be identified by IHC, providing a more specific diagnosis and offering a beneficial impact in maternal and fetal management.
Department of Pathology and Laboratory Medicine, New York-Presbyterian Hospital, New York, NY, USA. ans9112@med.cornell.edu
Audrey N
AN
Schuetz
Jeannette
J
Guarner
Michelle M
MM
Packard
Sherif R
SR
Zaki
Bahig M
BM
Shehata
Gabriela
G
Opreas-Ilies
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology; D002821:Chorioamnionitis / Q000382:microbiology* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D010920:Placenta / Q000382:microbiology* / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000473:pathology; D014777:Virus Diseases / Q000150:complications / Q000382:microbiology / Q000473:pathology; D055815:Young Adult