Objective.
—To review current knowledge regarding human immunodeficiency virus (HIV) infection in women and to derive from that data standards of care.
Data Sources.
—Selective review of pertinent articles addressing cervical disease, pelvic inflammatory disease, sexually transmitted diseases, contraception, and pregnancy in HIV-infected women. A computer-assisted search was used to identify relevant articles on pharmacokinetics of drugs in women and oral contraceptive—drug interactions.
Data Extraction.
—Pertinent data were abstracted from case-control, cohort studies, clinical trials, and pharmacokinetic studies.
Data Synthesis.
—Few studies have been performed to define the clinical course of HIV infection in women. Gender-specific manifestations, such as cervical neoplasia, pelvic inflammatory disease, and vaginal moniliasis, appear to pursue a more aggressive course in HIV-infected women. Little is known about the pharmacokinetics of drugs for HIV and related infections. Oral contraceptives may alter the metabolism of some drugs used in HIV-infected women. An approach to the routine treatment of HIV-infected women is summarized.
Conclusions.
—Little is currently known regarding the natural course of HIV infection in women. Women infected with HIV should be followed up frequently with specific attention paid to the reproductive system. Additional studies should be conducted to determine the impact of HIV on gender-specific diseases.(JAMA. 1991;266:2253-2258)