Gonadotoxic effect of antiretroviral therapy in hiv-infected women


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Materials and methods. This prospective clinical study included 191 patients who presented for assisted reproductive technologies (ART) treatment. The main group consisted of 95 HIV-infected women; the control group included 96 HIV-seronegative patients. There were 89 and 113 treatment cycles, respectively. The quantitative assessment of mtDNA copy number was carried out in 78 and 111 samples of cumulus cells, respectively, using real-time polymerase chain reaction (PCR) method. Results. Duration of HIV infection in patients was 8 (6; 11) years, third subclinical stage of the disease prevailed (61.05%). All patients received ARVT, the median treatment duration was 4 years (2; 6.5). The patients of the groups were similar in age (34 and 34 years; p=0.16), body mass index (22 and 22 kg/m2; p=0.62), duration (6.9 and 5.2; p=0.12) and factors of infertility. The assessment of outcomes ofIVFprograms showed lower rate of biochemical pregnancy (19.2% and 36.5%), р=0.03), clinical pregnancy (11.5% and 31.3%; р=0.008) and live birth (7.7% and 23.9%;р=0.007) in HIV-infected patients in comparison with HIV-seronegative women. mtDNA copy number in cumulus cells in HIV-infected women was statistically significantly lower than one in patients without HIV infection (566.7 (229.1) and 639.7 (197); р=0.02). The obtained data revealed inverse relationship between mtDNA level in cumulus cells and duration of ARVT (r=-0.228; р=0.04). Patients receiving ARVT more than one year showed a statistically significantly lower mtDNA content in cumulus cells than women from the control group (505.3(175) and (639.7(197.9), respectively; р=0.001). Conclusion. Lower rate of achieving pregnancy through IVF programs in HIV-infected women is due to gonadotoxic effect of ARVT.

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作者简介

E. Mityurina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: mity-elena@yandex.ru
PhD, researcher, the 1st Gynecological Department 117997, Russia, Moscow, Ac. Oparina str. 4

S. Perminova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: perisvet@list.ru
MD, leading researcher, the 1st Gynecological Department 117997, Russia, Moscow, Ac. Oparina str. 4

F. Selimova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: doc.fselimova@mail.ru
postgraduate student, the 1st Gynecological Department 117997, Russia, Moscow, Ac. Oparina str. 4

O. Burmenskaya

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: o_bourmenskaya@oparina4.ru
Doctor of Biological Sciences, head of the Laboratory of Oncological Genetics 117997, Russia, Moscow, Ac. Oparina str. 4

N. Kozyrina

Central Research Institute of Epidemiology, Federal Service on Customers' Rights Protection and Human Well-being Surveillance

Email: nad-kozyrina@yandex.ru
PhD, researcher 111123, Russia, Moscow, Novogireevskaya str., bldg. 3a. Tel.: +79167151018

A. Kravchenko

Central Research Institute of Epidemiology, Federal Service on Customers' Rights Protection and Human Well-being Surveillance

Email: alexey-kravtchenko@yandex.ru
MD, professor, leading researcher 111123, Russia, Moscow, Novogireevskaya str., bldg. 3a. Tel.: + 74953660518

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