Email this article Clinical characteristics and obstetrical principals at HIV-infected women in Saint Petersburg
- Authors: Niauri D.A.1, Yakovlev A.A.2, Penchuk T.E.2, Rad´kova Y.V.2, Kukol´nikova Y.A.2, Musatova E.V.2, Khubulava N.V.1
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Affiliations:
- St. Petersburg State Univrsity
- Clinical infectious diseases hospital named after S. P. Botkin
- Issue: Vol 63, No 5 (2014)
- Pages: 64-72
- Section: Articles
- URL: https://journal-vniispk.ru/jowd/article/view/2698
- DOI: https://doi.org/10.17816/JOWD63564-72
- ID: 2698
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Abstract
Objective: to determine the clinical course of HIV infection, pregnancy and delivery in HIV-infected women. Materials and Methods: the analysis of 1483 clinical records of the HIV-infected women, who were delivered in specialized infectious and obstetric department in Clinical infectious diseases hospital named after S.P. Botkin in 2011-2013. Results: Average age of patients - 28,2 ± 1,2 years. Vast majority of women (78,5 %) knew about the diagnosis “HIV-infection” before pregnancy. The sexual way of transmission dominated (67,6 %) among patients with the detected mechanism of HIV-transmission. Full three-step ARV prevention was performed in 82,4 % (1222) cases. The average amount of patients with 4th stage of HIV infection was 49,2 % (730), thus the number of women in labor with the 4th stage of HIV infection increased from 19,4 to 55,6 % in 2011-2013. There is a high percentage of the coinfection of HIV infection and chronic viral hepatitis C or B + C (50,8 %). The most frequent complications of pregnancy and labour at the HIV-infected women are: iron deficiency anemia, chronic placentary insufficiency, eclampsy, premature discharge of amniotic fluid. Every third pregnant has a combination of these pregnancy complications. Frequency of premature birth was 23,5 %. The majority of pregnant women had vaginal labors (67,3 %) Cesarean sections were performed in 32,7 % cases. Conclusion: In St. Petersburg in 2011-2013 significantly increased the number of women with clinically significant manifestations of HIV infection on the 4th stage of secondary diseases. The most frequent clinical manifestations of 4A stage of HIV infection were fungal (candidiasis) lesion of the mucous genitals, mouth and viral (HSV) lesions of the skin and mucous membranes. The major complications of pregnancy in HIV-infected women are anemia and chronic placental insufficiency. Almost one in four pregnancies ends premature birth. Remains high percentage of cesarean sections, including those caused by infectious indications.
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##article.viewOnOriginalSite##About the authors
Dariko Aleksandrovna Niauri
St. Petersburg State Univrsity
Email: d.niauri@mail.ru
MD, PhD professor, the head of obstetrics, gynecology and reproductology department, Faculty of Medicine
Aleksej Avenirovich Yakovlev
Clinical infectious diseases hospital named after S. P. Botkin
Email: iakovlevhome1956@yahoo.com
head doctor
Tatyana Efimovna Penchuk
Clinical infectious diseases hospital named after S. P. Botkin
Email: t.penchuk@yandex.ru
head of the maternity ward
Yulija Valer’evna Rad´kova
Clinical infectious diseases hospital named after S. P. Botkin
Email: ul-radkova@yandex.ru
obstetrician-gynecologist
Yulija Arkad’evna Kukol´nikova
Clinical infectious diseases hospital named after S. P. Botkin
Email: kukolnikova@mail.ru
obstetrician-gynecologist
Ekaterina Vladimirovna Musatova
Clinical infectious diseases hospital named after S. P. Botkin
Email: createfick@mail.ru
obstetrician-gynecologist
Nina Vladimirovna Khubulava
St. Petersburg State Univrsity
Email: d.niauri@mail.ru
Faculty of Medicine
References
- Айламазян Э. К., ред. Акушерство. Национальное руководство. М.: ГЭОТАР-Медиа. 2013; 1200.
- ВОЗ. ВИЧ/СПИД. Информационный бюллетень № 360 Октябрь 2013 г. Доступен по: http://www.who.int/mediacentre/factsheets/fs360/ru/ (дата обращения 15.05.2014).
- Горленко А. В., Ворошилина Е. С., Коновалов В. И., Сергеев А. Г., Кива Л. Д. Клинико-иммунологические особенности течения беременности и родов при ВИЧ-инфекции. Уральский медицинский журнал. 2004; 4: 13-5.
- Дворак C. И., Степанова Е. В., Сизова Н. В., Рассохин В. В., Малькова Т. В. Причины прекращения ВААРТ. Результаты длительного наблюдения за больными ВИЧ- инфекцией. ВИЧ-инфекция и иммуносупрессия. 2011; 3 (3): 52-7.
- Пантелеева О. В., Самарина А. В., Гаврилова С. П., Рассохин В. В., Беляков Н. А. Женщины и дети в развитии эпидемии ВИЧ-инфекции. ВИЧ-инфекция и иммуносупрессии. 2013; 5 (4):111-2.
- Пенчук Т. Е., Жук А. В., Яковлев А. А., Рахманова А. Г. Состояние новорожденных по данным акушерского отделения ГИБ № 30 за 2005 год. В альманахе: «Инфекционные болезни-2004» СПб. 2005; 83-4.
- Петрова Л. В., Пенчук Т. Е., Рахманова А. Г., Яковлев А. А. Социально-эпидемиологическая характеристика беременных с ВИЧ-инфекцией по материалам отделения № 16 ГИБ № 30 им. С. П. Боткина. В альманахе: «Инфекционные болезни - 2004» СПб. 2005; 144-9.
- Садовникова В. Н. Особенности заболеваемости ВИЧ-инфекцией у детей и меры по профилактике перинатальной трансмиссии ВИЧ-инфекции. Педиатрия. 2010; 1: 14-20.
- Справка ВИЧ-инфекция в Российской Федерации в 2013 г. Доступен по: http://www.hivrussia.ru/doc/docs.shtml (дата обращения 15.05.2014).
- Briand N., Jasseron C., Sibiude J., Azria E., Pollet J., Hammou Y., Warszawski J., Mandelbrot L. Cesarean section for HIV-infected women in the combination antiretroviral therapies era, 2000-2010. Am J Obstet Gynecol. 2013; 209 (4): 335.e1-335.e12.
- Cotter A. M., Garcia A. G., Duthely M. L., Luke B. Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth? J Infect Dis. 2006; 193 (9): 1195-201.
- Ellis J., Williams H., Graves W., Lindsay M. K. Human immunodeficiency virus infection is a risk factor for adverse perinatal outcome. Am J Obstet Gynecol. 2002; 186 (5): 903-6.
- Fiore S., Semprini A. E., Ravizza M., Bucceri A., Muggiasca M. L., Guerra B., Spinillo A., Pardi G. The changing HIV epidemic in Italian pregnant women. Eur J Obstet Gynecol Reprod Biol. 2000; 91 (2): 149-53.
- Frank K. A., Buchmann E. J., Schackis R. C. Does human immunodeficiency virus infection protect against preeclampsia-eclampsia? Obstet Gynecol. 2004; 104 (2): 238-42.
- Kourtis A. P., Schmid C. H., Jamieson D. J., Lau J. Use of antiretroviral therapy in pregnant HIV- infected women and risk of premature delivery: a meta-analysis. AIDS. 2007; 21 (5): 607-15.
- Kreitchmann R., Li S. X., Melo V. H., Fernandes Coelho D., Watts D. H., Joao E., Coutinho C. M., Alarcon J. O., Siberry G. K. Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: a cohort study. BJOG - 2014. Available at: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12680/abstract (accessed 07. 03.2014)
- Machado E. S., Krauss M. R., Megazzini K., Coutinho C. M. Hypertension, preeclampsia and eclampsia among HIV-infected women from Latin America and Caribbean countries. J Infect. 2014; 68 (6): 572-80.
- Paterson D. L., Swindells S., Mohr J., Brester M., Vergis E. N., Squier C., Wagener M. M., Singh N. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000; Jul 4, 133 (1): 21-30.
- Reitter A., Stücker A., Linde R., Königs C., Knecht G., Herrmann E., Schlößer R., Louwen F., Haberl A. Pregnancy complications in HIV-positive women: 11-year data from the Frankfurt HIV Cohort. HIV Med. 2014 Oct;15 (9):525-36
- Townsend C. L., Cortina-Borja M., Peckham C. S., Tookey P. A. Antiretroviral therapy and premature delivery in diagnosed HIV-infected women in the United Kingdom and Ireland. AIDS. 2007; 21 (8): 1019-26.
- Wimalasundera R. C., Larbalestier N., Smith J. H., de Ruiter A., McG Thom S. A., Hughes A. D., Poulter N., Regan L., Taylor G. P. Pre-eclampsia, antiretroviral therapy, and immune reconstitution. Lancet. 2002; 12 (360):1152-54.
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