REPRODUCTIVE DISORDERS AND THEIR PATHOGENETIC MECHANISMS IN WOMEN WITH HIV

Abstract

Background . Highly active antiretroviral therapy (ART) has increased the life expectancy of people living with the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Advances in scientific knowledge and, in particular, in the management of an HIV-infected pregnant woman have also reduced the risk of mother-to-child transmission of HIV. Aims . Consider the current problems of gynecological and reproductive health disorders and the pathophysiological aspects of these disorders in HIV-infected women. Methods . Review of Russian and international scientific publications related to gynecology, reproductive health and HIV infection from indexed online journals and relevant websites using Pubmed and Google search from 1990 to March 2019. Results. In recent years, the proportion of HIV-infected women has increased and the role of sexual transmission of infection has increased, as well as the active involvement of women of reproductive age in the HIV epidemic. In HIV-infected pregnant women who did not receive HAART, the frequency of obstetric complications, labor and adverse outcomes in children is increased. HIV infection can reduce the fertility of women at any stage of the disease, marked violations of the menstrual cycle and ovulation, reduced ovarian reserve and the quality of oocytes. In HIV-infected patients, weight loss and dystrophy, impaired thyroid function, adrenal glands and hypogonadism are recorded. Violations of the menstrual, ovulatory function can occur for a variety of reasons that are not directly related to their illness, but to multiple stressors. HIV-positive women suffer from increased frequency and severity of pelvic infections and precancerous and malignant lesions of the cervix. Conclusions. Gynecological, reproductive needs, as well as the specifics of monitoring an HIV-positive woman are not sufficiently assessed, are not optimal and are largely ignored, which can negatively affect their quality of life and efforts to combat the HIV epidemic.