Chronic Plasma Cell Endometritis in Hysterectomy Specimens of HIV-Infected Women: A Retrospective Analysis

[摘要] Objective:Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiencyvirus (HIV)-infected women. We sought to evaluate endometrial pathology among HIVinfectedwomen requiring hysterectomy to explore if endometritis may be common among thesepatients.Methods:We performed a retrospective analysis of uterine pathology specimens obtained fromHIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and1997 matched for age, surgical indication, and history of gonadotropin-releasing hormone (GnRH)use. Cases were evaluated for the presence of plasma cells and assigned a grade between 0 and 3.Results:Indications included cervical dysplasia (4), carcinoma in situ (2), abnormal uterinebleeding (3), and adnexal mass (3). Some degree of abnormal uterine bleeding occurred in all cases.Plasma cell endometritis was twice as common in HIVoinfected women compared to HIV-negativespecimens (11/11 versus 11/22) (P< 0.05). Plasma cell endometritis was also of a higher grade inspecimens from HIV-infected women than in controls (P< 0.001).Conclusion:Chronic endometritis was common and of a higher grade among HIV-infectedwomen requiring hysterectomy in our series. Diagnosis and treatment of endometritis should beconsidered in HIV-infected women with uterine bleeding and/or tenderness. We speculate thatantiretroviral and/or antimicrobial treatment for endometritis may effectively treat endometritis andeliminate the need for surgery in some HIV-infected women. We suggest that consideration andtreatment of endometritis in HIV-1 infected women being evaluated for possible hysterectomy hasthe potential to reduce costs and morbidity for patients and providers who may be exposed duringsurgical procedures.

[学科分类] 妇产科学