The human immunodeficiency virus (HIV) continues to be a major global public health issue, having claimed 34 million lives so far. 38 million people are living with HIV around the world. 2 million of these people are children. The high medical, social and economic significance of HIV infection is determined by the widespread and severe course of the disease. Every year, up to 2.7 million new infections are registered worldwide. Up to 30 % of cases of HIV infection in pregnant women are detected for the first time during pregnancy-related examinations. Every year, 1.49 million babies are born to HIV-positive women worldwide. The current tasks are to preserve the health of women and reduce the risk of transmission of HIV infection from mother to child. The article analyzes the results of Russian and foreign studies concerning the problems of pregnant HIV-positive women, published in international databases. The aim of the work is to analyze the data of studies aimed at studying the effect of HIV infection on the course of pregnancy.
Aim. To establish cut-off values for the concentrations of complement C3 and ceruloplasmin, diagnostic markers of reduced antral follicle count (AFC) and anti-Müllerian hormone (AMH) which both indicate diminished ovarian reserve, in women of reproductive age.Materials and Methods. Here we enrolled 864 women (18-40 years of age, average age 31.70 ± 5.14 years) who underwent an annual medical examination in 2017–2019 in the Irkutsk Region and the Republic of Buryatia. Reduced AFC was defined as ≤ 5 antral follicles in each ovary at pelvic ultrasound examination whilst reduced AMH was defined as < 1.2 ng/mL. In total, 112 women had reduced ovarian reserve and 752 were included into the control group. In addition to AMH, we also measured serum prolactin, gonadotropins, inhibin B, estradiol, complement C3, and ceruloplasmin using enzyme-linked immunosorbent assay. The cut-off values were determined by plotting a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC).Results. The cut-off level of complement C3 was 894 (867; 1355.5) mg/mL [AUC: 0.769 (0.635; 0.904)] in women with reduced AFC (≤ 5) and 981.5 (916.5; 1467.5) mg/mL [AUC: 0.62 (0.493; 0.746)] in women with reduced AMH (< 1.2 ng/mL). The cut-off level of ceruloplasmin was 1.745 (1.625; 1.975) mg/mL [AUC: 0.859 (0.759; 0.96)] in women with reduced AFC (≤ 5) and 1.975 (1.665; 2.15) mg/mL, [AUC: 0.662 (0.542; 0.782)] in women with reduced AMH (< 1.2 ng/mL).Conclusion. We have established the cut-off values for the serum complement C3 and ceruloplasmin in women with reduced AFC and AMH, indicators defining diminished ovarian reserve in women of reproductive age.
Uterine fibroid is one of the most common gynecological diseases in women of reproductive age and many aspects of this disease remain the subject of investigation. In particular, the role of the metabolic syndrome is of interest as a potential predictor of uterine fibroid or a comorbid condition that has pathogenetic significance. The aim of this literature review is to systematize current data on the prevalence and associations of the metabolic syndrome and uterine fibroid in women of reproductive age. Literature search was carried out using the scientific literature databases eLIBRARY, PubMed, NCBI, CyberLeninka, and the official IDF website for the period from 2010 to 2022. In PubMed search, we used the following terms: uterine fibroid, metabolic syndrome, uterine fibroid and metabolic syndrome, uterine myoma and metabolic syndrome, uterine myoma and metabolic disorders, uterine myoma and MetS. A total of 439 sources were analized, 32 sources met the search criteria. Results. An analysis of the largest epidemiological studies conducted in recent years, both in non-selective populations and in hospital samples, demonstrates a significant prevalence of both uterine fibroid and metabolic syndrome among women. The results presented in the publications which were included in the review indicate that there is a relationship between the presence of uterine fibroid and the manifestations of the metabolic syndrome. Conclusions. Uterine fibroid and metabolic syndrome are mutually aggravating conditions. Women with uterine fibroid have a worse risk profile for cardiovascular disease, and the presence of metabolic syndrome increases the risk of uterine fibroid. One of the ways to reduce the risk of occurrence and growth of uterine fibroid is the timely correction of the metabolic syndrome and its components. On the other hand, the presence of uterine fibroid should be considered as a basis for active detection of metabolic disorders and cardiovascular risks.
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