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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2023№12
The use of a subcutaneous...

The use of a subcutaneous contraceptive implant in women with chronic viral infections

DOI
https://dx.doi.org/10.18565/aig.2023.295

Samarina A.V., Mozaleva O.L., Martirosian M.M., Skryabneva T.S., Shamaeva N.S., Filatova M.P.

1) Center for the Prevention and Control of AIDS and Infectious Diseases, St. Petersburg, Russia; 2) Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia

The proportion of women with HIV continues to grow due to the prevalence of sexual transmission route of the infection. Most of the patients are reproductive-aged women who are not always interested in pregnancy and need counseling on family planning issues. The frequency of unwanted pregnancies and obstetric complications in HIV-infected patients is higher than frequency in the population, thus the risks of maternal and infant mortality in this group of patients are increased. Unwanted and unplanned pregnancy in women with HIV is a predictor of low commitment to monitoring and receiving prevention of perinatal HIV transmission. The task of a practitioner working with this group of patients is to conduct detailed family planning counseling. During the choice of contraception, it is necessary to assess the safety and effectiveness of the chosen method, taking into account high comorbidity and drug interactions, in particular interaction with antiretroviral therapy (ART). There was a study of 41 women with HIV who used a contraceptive radiopaque implant containing 68 mg of etonogestrel (ETG). The study was conducted at the Center for the Prevention and Control of AIDS and Infectious Diseases, St. Peterburg. When the patients used the implant with ETG, there were no significant changes in the number of CD4 lymphocytes, hemoglobin levels, ALT and AST, body weight, as well as serious adverse events; these findings confirm the safety of using this contraception method in HIV-infected women and patients with HIV coinfection and chronic hepatitis C (HCV). There was a decrease in the average level of HIV RNA in dynamics which could be connected with an increase in patients receiving ART; their percentage increased from 85% to 100% during the study period.
Conclusion: Before administering hormonal contraception or starting ART/changing the ART regimen in patients with HIV, it is necessary to evaluate possible drug interactions. It is important to integrate family planning services in the treatment of women with chronic viral infections and provide them with contraceptives via regional HIV prevention programs.

Authors’ contributions: Samarina A.V., Mosaleva O.L., Martirosian M.M., Shamaeva N.S., Skryabneva T.S. – collecting and processing of the material, Samarina A.V., Filatova M.P. – writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Center for the Prevention and Control of AIDS and Infectious Diseases, St. Petersburg.
Patient Consent for Publication: The patients provided an informed consent for the publication of their data.
For citation: Samarina A.V., Mozaleva O.L., Martirosian M.M., Skryabneva T.S., Shamaeva N.S., Filatova M.P. The use of a subcutaneous contraceptive implant in women with chronic viral infections.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (12): 169-179 (in Russian)
https://dx.doi.org/10.18565/aig.2023.295

Keywords

HIV and hormonal contraception
etonogestrel implant in women with HIV
chronic viral infections and contraception
family planning and HIV infection
Implanon NKST contraceptive
Full text (in Russian)

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Received 14.12.2023

Accepted 21.12.2023

About the Authors

Anna V. Samarina, Dr. Med. Sci., Head of the Department of Motherhood and Childhood, Center for the Prevention and Control of AIDs and Infectious Diseases, Saint Petersburg, Russia; Professor of the Department of Socially Significant Infections and Phthisiopulmonology, Academician I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia, +7(921)931-72-57, avsamarina@mail.ru, https://orcid.org/0000-0003-1438-2399, SPIN-код: 2878-7130,
179 lit. A and B Naberezhnaya Obvodnogo Kanala, Saint Petersburg, 190103, Russia.
Olga L. Mozaleva, PhD, Department of Motherhood and Childhood, Center for the Prevention and Control of AIDs and Infectious Diseases, Saint Petersburg, Russia, mozaleva.o@yandex.ru, https://orcid.org/0000-0003-4682-9394, 179 lit. A and B Naberezhnaya Obvodnogo Kanala, Saint Petersburg, 190103, Russia.
Margarita M. Martirosian, PhD, Department of Motherhood and Childhood, Center for the Prevention and Control of AIDs and Infectious Diseases, Saint Petersburg, Russia, martirosianmm@mail.ru, 179 lit. A and B Naberezhnaya Obvodnogo Kanala, Saint Petersburg, 190103, Russia.
Tatiana S. Skryabneva, MD, Department of Motherhood and Childhood, Center for the Prevention and Control of AIDs and Infectious Diseases, Saint Petersburg, Russia, skryabneva.tanya@mail.ru, 179 lit. A and B Naberezhnaya Obvodnogo Kanala, Saint Petersburg, 190103, Russia.
Natalia S. Shamaeva, MD, Department of Motherhood and Childhood, Center for the Prevention and Control of AIDs and Infectious Diseases, Saint Petersburg, Russia, nataljklokova@mail.ru, 179 lit. A and B Naberezhnaya Obvodnogo Kanala, Saint Petersburg, 190103, Russia.
Marina P. Filatova, MD, Department of Motherhood and Childhood, Center for the Prevention and Control of AIDs and Infectious Diseases, Saint Petersburg, Russia, marinafilatova1964@mail.ru, 179 lit. A and B Naberezhnaya Obvodnogo Kanala, Saint Petersburg, 190103, Russia.
Corresponding author: Anna V. Samarina, avsamarina@mail.ru
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