The levonorgestrel-releasing intrauterine system (LNG-IUS) in HIV-infected women—effects on bleeding patterns, ovarian function and genital shedding of HIV

Safe and effective contraceptives are needed for human immunodeficiency virus (HIV)-infected women. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a highly effective contraceptive with additional health benefits. The objective of this study was to evaluate the effects of the LNG-IUS among HIV-infected women. Twelve systematically managed HIV-infected women were studied prospectively. Following a 2-month run-in period the subjects had an LNG-IUS inserted and were followed up for 1 year. Patterns of bleeding blood haemoglobin and CD4-lymphocyte content plasma HIV RNA serum levels of LNG of estradiol (E/2) and of ferritin and genital shedding of HIV RNA were monitored. Menstrual bleeding was reduced significantly during the use of the LNG-IUS; this was associated with slight increases in serum haemoglobin and ferritin levels. Serum E/2 concentrations remained in the follicular range in all subjects. Among subjects using antiretroviral medication the proportion of cervicovaginal lavage specimens with detectable HIV RNA was 10% before and after the insertion of the LNG-IUS. The effects of the LNG-IUS on bleeding patterns body iron stores and ovarian function were similar to those seen in healthy women. Genital shedding of HIV RNA was not affected by the LNG-IUS. These data encourage further studies on the effects of the LNG-IUS on reproductive health among HIV-infected women. (authors)