Features of the course of HIV infection and the structure of comorbid diseases in women of childbearing age during antiretroviral therapy

The aim: to analyze the characteristics of HIV infection and the structure of comorbid diseases in women of childbearing age.
Materials and methods. A total of 100 women of childbearing age were studied at the Republican Clinical Infectious Diseases Hospital. The average age was 42.5±0.6 years (range: 35 to 52 years). The duration of HIV infection was 15.6±1.2 years (range: 2 to 26 years). Transmission routes: sexual (63%) and parenteral (37%), HCV infection (42%) (90% treated). Marital status: married (62%), cohabiting (28%), living alone (10%). 78% of patients were permanently employed. All women had children, only one child was infected with HIV. The women had from one to five children (2.4±0.5 children). ART initiation after diagnosis was 7.7±1.3 years (range, 0 to 21 years). ART duration was 7.9±1.5 years (range, 1 to 19 years). The number of antiretroviral therapy (ART) regimens was 2.6±0.3 (range, 1 to 4 regimens). HIV infection stages: 3–6%, 4A–5%, 4B–2%, 4C–87% (Russian classification, 2006).
Results and discussion. All women studied were successfully receiving ART. Before ART initiation, the average HIV RNA blood level was 375,240±15,400 copies/ml. At the time of the study, HIV RNA was undetectable in the blood of all 100 patients (a decrease of 5.6 log10) (p≤0.001). Furthermore, before ART initiation, the CD4 lymphocyte count averaged 285.5±14.3 cells/μl, while at the time of the study it was 664.5±13.7 cells/μl (a 2.3-fold increase) (p≤0.001). A study of concomitant pathology revealed the following comorbidity patterns: CNS lesions (87%), cardiovascular system (65%), gastrointestinal tract (37%), kidneys (15%), bone and joint diseases (28%), endocrine system (33%), eye diseases (10%), reproductive system diseases (18%), oncology (7%), opportunistic infections (24%), and blood system diseases (18%).
Conclusion. The predominant comorbidities in women with HIV infection of childbearing age include disorders of the central nervous system, cardiovascular system, gastrointestinal tract, and endocrine system, as well as bone and joint damage. Typically, the causes of comorbid pathology are related directly to HIV, opportunistic infections, antiretroviral medications, and individual factors.

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