The levonorgestrel-releasing intrauterine system in human immunodeficiency virus–infected women: a 5-year follow-up study

Objective We sought to assess the effects of long-term use and safety of the levonorgestrel-releasing (LNG)-intrauterine system (IUS) among human immunodeficiency virus (HIV)-infected women in comparison with HIV-infected women not using the device. Study Design Fifteen women using the LNG-IUS and t...

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Published in:American journal of obstetrics and gynecology 2011-02, Vol.204 (2), p.126.e1-126.e4
Main Authors: Heikinheimo, Oskari, MD, PhD, Lehtovirta, Päivi, MD, PhD, Aho, Inka, MD, Ristola, Matti, MD, PhD, Paavonen, Jorma, MD, PhD
Format: Article
Language:English
Subjects:
Analysis of Variance
Biological and medical sciences
contraception
Contraceptive Agents, Female - adverse effects
Contraceptive Agents, Female - therapeutic use
Female
Follow-Up Studies
Gynecology. Andrology. Obstetrics
HIV Infections
human immunodeficiency virus infection
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infectious diseases
Intrauterine Devices, Medicated
intrauterine systems
Levonorgestrel - administration & dosage
Levonorgestrel - therapeutic use
Lymphocyte Count
Medical sciences
Obstetrics and Gynecology
Statistics, Nonparametric
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Women
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Summary:Objective We sought to assess the effects of long-term use and safety of the levonorgestrel-releasing (LNG)-intrauterine system (IUS) among human immunodeficiency virus (HIV)-infected women in comparison with HIV-infected women not using the device. Study Design Fifteen women using the LNG-IUS and their 25 age- and CD4+ lymphocyte count–matched control subjects with annual follow-up data were followed up for 5 years. Results No unplanned pregnancies or pelvic infections occurred among the LNG-IUS users. Altogether, 12 (80%) of the LNG-IUS users continued its use up to 5 years. Annual CD4+ lymphocyte counts were similar in the LNG-IUS users and control subjects throughout the follow-up period. The hemoglobin levels increased initially ( P < .005) and remained higher among the LNG-IUS users ( P < .02). Pap smears displayed non-squamous intraepithelial lesion cytology in ≥85% of cases in both groups. Conclusion No unfavorable effects on the course of HIV infection were noted during long-term use of the LNG-IUS. Dual protection by means of an LNG-IUS and condoms might be an ideal contraceptive strategy for HIV-infected women.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2010.09.002