Morphological characteristics of endometrium in patients of reproductive age with viral hepatitis type C

The purpose of the study was to investigate the morphological features of endometrium in patients with viral hepatitis type C.

A morphological survey was conducted involving endometrium sections stained with hematoxylin and eosin and Van Gieson's picrofuchsin collected from 140 women of reproductive age, among them 70 patients were diagnosed with chronic hepatitis type C (CHC) infection with minimal (40 patients) and moderate activity (30 patients), and 70 women suffered from endometrial proliferative diseases without viral hepatitis (comparison group). In addition, 36 women with CHC and 36 women without CHC underwent immune histochemical test (IHC) of paraffin sections aimed at investigating the expression level of estrogen (ERα) and progesterone (PR) receptors and proliferation marker Ki-67. Endometrial biopsy samples were collected on the 10th to 14th day and the 15th to 18th day of the menstrual cycle.

Focal changes of endometrium in the form of uneven entering of the endometrium into the next phase of the menstrual cycle with the dominating proliferative phase were found in chronic hepatitis C patients. The number of patients having proliferative activity in the endometrium combined with inflammation increased as viral hepatitis became more active. Immune histochemical test showed the prevalence of the expression levels of ERα and PR receptors in the endometrial stroma. Increased expression of Ki-67 was observed mainly in the glandular epithelium and accrued together with the increment in the CHC activity.

Endometrial pathology in patients of reproductive age with chronic hepatitis type C is characterized primarily by proliferative forms with the increasing mismatch between the nature of structural changes and mucous phase of the menstrual cycle prompting suggestions that direct effect of hepatitis C virus on endometrium is possible.