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

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 2; pp. 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: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2011; Elsevier
• 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; human immunodeficiency virus infection; intrauterine systems; contraception; Human; Immunopathology; Intrauterine administration; Gynecology; Levonorgestrel; AIDS; Immune deficiency; Obstetrics; Progestagen; Infection; Follow up study; Viral disease; Female; Contraceptive; Woman; Public health
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.09.002

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.