urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.4.133SLGEMWurmj-2297Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsКлинические особенности беременности, родов и послеродового периода у женщин с ВИЧ-инфекцией: анализ современных данныхClinical Features of Pregnancy, Childbirth, and The Postpartum Period in Women with HIV Infection: An Analysis of Current Data Annahttps://orcid.org/0009-0009-5512-3554ЗахароваА. В.ZakharovaA. V.

Анна Вячеславовна Захарова – акушер-гинеколог Областного перинатального центра

Екатеринбург

Anna V. Zakharova – Obstetrician-Gynecologist of the Regional Perinatal Center

Ekaterinburg

anna_vip93@mail.ruhttps://orcid.org/0000-0001-8640-8418КовалёвВ. В.KovalevV. V.

Владислав Викторович Ковалёв – доктор медицинских наук, профессор кафедры акушерства и гинекологии с курсом медицинской генетики, институт педиатрии и репродуктивной медицины

Екатеринбург

Vladislav V. Kovalev – Doctor of Sciences (Medicine), Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course, Institute of Pediatrics and Reproductive Medicine

Ekaterinburg

https://orcid.org/0000-0003-3451-9946ОсипчукД. О.OsipchukD. O.

Дмитрий Олегович Осипчук – кандидат медицинских наук, член Королевского колледжа акушеров-гинекологов (MRCOG)

Екатеринбург

Dmitry O. Osipchuk – Candidate of Sciences (Medicine), Member of the Royal College of Obstetricians and Gynaecologists (MRCOG)

Ekaterinburg

Областная детская клиническая больницаРоссияRegional Children’s Clinical HospitalRussian FederationУральский государственный медицинский университетРоссияUral State Medical UniversityRussian FederationНезависимый исследовательРоссияIndependent ResearcherRussian Federation202618082026254133–150Copyright © Захарова А.В., Ковалёв В.В., Осипчук Д.О., 20262026Захарова А.В., Ковалёв В.В., Осипчук Д.О.Zakharova A.V., Kovalev V.V., Osipchuk D.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2297

Инфекция вируса иммунодефицита человека (ВИЧ) у беременных является одной из наиболее острых проблем современного акушерства и инфектологии. В последние десятилетия, благодаря применению антиретровирусной терапии, достигнута ощутимая положительная динамика относительно контроля показателей вирусной нагрузки, оппортунистических инфекций и вертикальной передачи ВИЧ. Вместе с тем имеется ряд нерешенных вопросов: влияние антиретровирусной терапии на плаценту, ее формирование, внутриутробное развитие плода, особенности течения коморбидных состояний, связь ВИЧ-инфекции с развитием осложнений в течение беременности, роль генетических маркеров в прогнозировании осложнений гестационного процесса. В литературном обзоре систематизированы современные данные о клинических особенностях беременности, родов и послеродового периода у женщин с ВИЧ-инфекцией, а также обозначены перспективные направления дальнейших исследований.

Цель настоящего обзора обобщить современные данные о течении беременности, родов и послеродового периода у женщин с положительным ВИЧ-статусом, проанализировать доступные отечественные и зарубежные клинические исследования, оценить влияние ВИЧ-инфекции на плаценту, включая гистологические и иммуногистохимические изменения.

Материалы и методы . При подготовке обзорной статьи использованы публикации из международных и российских научных ресурсов: PubMed, Cochrane Library, а также национальные базы eLibrary.ru и материалы профильных журналов по акушерству и гинекологии, инфекционным болезням и эпидемиологии, генетике. В анализ преимущественно включались работы 2018–2026 гг., при необходимости привлекались более ранние ключевые публикации. Поиск осуществлялся с использованием комбинаций ключевых слов, а также их английских эквивалентов: «беременность, ВИЧ-инфекция, осложнения беременности, плацента, вертикальная передача ВИЧ, преэклампсия, генетика» ( англ. pregnancy, HIV infection, pregnancy complications, placenta, vertical transmission of HIV, genetics, preeclampsia). Отобранные публикации подвергались критической оценке, последующему распределению по тематическим направлениям и обобщению.

In modern obstetrics, the management of HIV-positive pregnancies has undergone a paradigm shift, primarily due to the widespread implementation of antiretroviral therapy. While these interventions have drastically reduced vertical transmission and maternal opportunistic infections, several clinicopathological challenges persist regarding the long-term impact on the maternal-fetal unit. Current scientific inquiry is focused on identifying biomarkers and genetic markers to enhance risk stratification.

The purpose of this review is to summarize current data on the course of pregnancy, childbirth, and the postpartum period in women with HIV-positive status, analyze available domestic and foreign clinical studies, and evaluate the effects of HIV infection on the placenta, including histological and immunohistochemical changes.

Materials and methods . When preparing the review article, publications from international and Russian scientific resources were used: PubMed/MEDLINE, Cochrane Library, as well as national databases eLibrary.ru and materials from specialized journals on obstetrics and gynecology, infectious diseases and epidemiology, and genetics. The analysis mainly included works from 2018–2026, with earlier key publications involved, if necessary. The search was carried out using combinations of keywords, as well as their Russian equivalents: “pregnancy, HIV infection, pregnancy complications, placenta, vertical transmission of HIV, genetics, preeclampsia”. The selected publications were critically evaluated, then divided into thematic areas and summarized.

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The authors declare that there are no conflicts of interest present.