Lecture On HIV in Gynecology: Manifestations, HPV Co-infection & Clinical Management | MBBS

Описание: In this comprehensive lecture for the MBBS 2023-2024 batch at Santiniketan Medical College & Hospital, we dive into the complex management of HIV-positive women. While HIV is often discussed as a systemic condition, its impact on gynecological health—from menstrual disorders to the aggressive progression of cervical cancer—requires a specialized clinical approach.

Key Topics Covered in This Lecture: ✅ HIV Viral Structure & Pathogenesis: A review of the Lentivirus structure (GP120/GP41) and how Reverse Transcriptase, Integrase, and Protease facilitate host genome integration [00:21]. ✅ Gynecological Manifestations: Why HIV-positive women are more prone to abnormal Pap smears and how lower CD4 counts correlate with menstrual dysfunction like amenorrhea [11:20]. ✅ HPV Co-infection: The dangerous synergy between HIV and HPV, leading to higher rates of Squamous Intraepithelial Lesions (SIL) and more aggressive cervical carcinoma [13:56]. ✅ Persistent Infections: Understanding why typical infections like Vulvovaginal Candidiasis present with atypical "non-albicans" strains and require weekly Fluconazole prophylaxis [24:33]. ✅ Diagnostic & Treatment Challenges: Why standard treatments like Cryotherapy are avoided due to high recurrence and the role of 5-Fluorouracil (5-FU) cream [27:30]. ✅ Screening Protocols: The necessity of more frequent follow-ups (3-4 monthly) and mandatory Colposcopy for patients with low CD4 counts [26:30].
Chapter Timestamps

[00:21] Structure of HIV: The Role of Retroviruses & Lentiviruses

[01:11] Viral Envelope: GP41 and GP120 Spike Proteins

[03:04] Pathogenesis: CD4 T-cell Affinity & Integration

[05:20] The Four Stages of HIV Presentation

[06:45] Transmission Routes: Mother-to-Child & Occupational Exposure

[08:23] Gynecological Manifestations in HIV Populations

[10:05] Abnormal Pap Smears & HPV Statistics

[11:20] Menstrual Disorders & CD4 Count Correlation

[13:56] High-Grade SIL & Cervical Cancer Risk

[16:19] Invasive Cervical Cancer: Aggression & Metastasis

[17:39] Sexually Transmitted Infections (STIs) in HIV Patients

[19:21] HPV DNA Persistence & Immune Clearance Failure

[22:15] Syphilis & Neurosyphilis in Seropositive Cases

[24:10] Pelvic Inflammatory Disease (PID) & Atypical Candidiasis

[26:30] Screening & Follow-up Protocols (The Rule of Follow-up)

[27:30] Treatment Modifications: Avoiding Cryotherapy


SANTINIKETAN MEDICAL COLLEGE & HOSPITAL
Real Classroom Demonstration/Lecture
On: OBSTETRICS & GYNAECOLOGY by Dr. Inisha Sarkar
(MBBS Batch: 2023-24)
Conducted on: 03-02-26