Lehtovirta Päivi, Paavonen Jorma, Heikinheimo Oskari
Department of Obstetrics and Gynecology, University of Helsinki, SF-00029 Helsinki, Finland.
Contraception. 2007 Jan;75(1):37-9. doi: 10.1016/j.contraception.2006.09.006. Epub 2006 Oct 25.
Safe and effective contraception is needed for women infected with human immunodeficiency virus (HIV). The levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective long-term contraceptive that reduces menstrual bleeding and may reduce the risk of pelvic inflammatory disease. Yet, little is known about LNG-IUS use in HIV-infected women.
Six HIV-infected women had the LNG-IUS inserted between March 1998 and October 2002, and were systemically followed for a mean of 45 months. Indications for LNG-IUS use were contraception in four women and menorrhagia in two women.
The LNG-IUS was well tolerated, and menstrual bleeding was reduced in all women. Blood hemoglobin levels increased in each subject, with mean levels being 123 g/L (SD=11.7) before LNG-IUS insertion and 135 g/L (SD=8.7) at 1 year (p=.01). Levels of circulating CD4 lymphocytes and Pap smear findings remained unchanged.
Our limited experience with LNG-IUS use in HIV-infected women is encouraging. The LNG-IUS may be used as an alternative to uterine surgery in HIV-infected women with menorrhagia.
感染人类免疫缺陷病毒（HIV）的女性需要安全有效的避孕方法。左炔诺孕酮宫内节育系统（LNG-IUS）是一种有效的长效避孕方法，可减少月经出血，并可能降低盆腔炎的风险。然而，关于HIV感染女性使用LNG-IUS的情况知之甚少。
1998年3月至2002年10月期间，6名感染HIV的女性植入了LNG-IUS，并进行了平均45个月的系统随访。使用LNG-IUS的指征为4名女性避孕，2名女性月经过多。
LNG-IUS耐受性良好，所有女性的月经出血均减少。每位受试者的血红蛋白水平均升高，LNG-IUS植入前平均水平为123 g/L（标准差=11.7），1年后为135 g/L（标准差=8.7）（p=0.01）。循环CD4淋巴细胞水平和巴氏涂片检查结果保持不变。
我们在HIV感染女性中使用LNG-IUS的有限经验令人鼓舞。LNG-IUS可作为HIV感染且月经过多女性子宫手术的替代方法。
