title: Morphologic changes in the placentas of HIV-positive women and their association with degree of immune suppression.
abstract: OBJECTIVE
  To provide baseline information regarding a possible association between specific histopathologic features of the placentas of HIV-positive women and the degree of immune suppression.
  
  
  METHODS
  A prospective single-blinded laboratory-based pilot study was conducted at Tygerberg Hospital, South Africa. The macroscopic and microscopic features of placentas from HIV-positive (n=91) and HIV-negative women (n=89) were compared and recorded using a standard template. Investigators were blinded to the participants' HIV status and CD4-positive cell count.
  
  
  RESULTS
  Placentas from the HIV-positive group were characterized by decreased weight and increased number of marginal infarcts relative to the HIV-negative group. The most important microscopic finding was the increased presence of villitis of unknown etiology (VUE) among the group of untreated HIV-positive women with CD4 cell counts of 200 cells/mm(3) or below.
  
  
  CONCLUSIONS
  Both macroscopic and microscopic differences relating to the degree of immune suppression were identified, which seemingly contradicts previous reports. Larger studies are warranted to define the function of antiretroviral therapy and VUE in the mechanism of mother-to-fetus transmission of HIV. Furthermore, the potential role of VUE in the pathophysiology of the compromised immune response observed among HIV-exposed but uninfected infants should be investigated.
authors.affiliation: Division of Anatomical Pathology, Stellenbosch University and National Health Laboratory Services Tygerberg Hospital, Cape Town, South Africa. vermaakanine@yahoo.com
authors.forename: Anine
authors.initials: A
authors.lastname: Vermaak
authors.forename: Gerhard B
authors.initials: GB
authors.lastname: Theron
authors.forename: Pawel T
authors.initials: PT
authors.lastname: Schubert
authors.forename: Martin
authors.initials: M
authors.lastname: Kidd
authors.forename: Ursula
authors.initials: U
authors.lastname: Rabie
authors.forename: Benedict M
authors.initials: BM
authors.lastname: Adjiba
authors.forename: Colleen A
authors.initials: CA
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D002824:Chorionic Villi / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000821:virology*; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D010865:Pilot Projects; D010920:Placenta / Q000276:immunology / Q000473:pathology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000821:virology*; D011446:Prospective Studies; D016037:Single-Blind Method; D013019:South Africa; D055815:Young Adult