Use of antimüllerian hormone to predict the menopausal transition in HIV-infected women

doi:10.1016/j.ajog.2016.07.048

Observational Study

. 2017 Jan;216(1):46.e1-46.e11.

doi: 10.1016/j.ajog.2016.07.048. Epub 2016 Jul 26.

Use of antimüllerian hormone to predict the menopausal transition in HIV-infected women

Rebecca Scherzer¹, Ruth M Greenblatt², Zaher O Merhi³, Seble Kassaye⁴, Geralyn Lambert-Messerlian⁵, Pauline M Maki⁶, Kerry Murphy⁷, Roksana Karim⁸, Peter Bacchetti⁹

Affiliations

¹ Department of Medicine, University of California, San Francisco, San Francisco, CA; San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA.
² Department of Medicine, University of California, San Francisco, San Francisco, CA; Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA. Electronic address: ruth.greenblatt@ucsf.edu.
³ Department of Obstetrics and Gynecology, Division of Reproductive Biology, New York University School of Medicine, New York, NY.
⁴ Department of Infectious Diseases, Georgetown University Medical Center, Washington, DC.
⁵ Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Providence, RI.
⁶ Departments of Psychiatry and Psychology, College of Medicine, University of Illinois at Chicago, Chicago, IL.
⁷ Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
⁸ University of Southern California, Los Angeles, CA.
⁹ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.

PMID: 27473002
PMCID: PMC5182170
DOI: 10.1016/j.ajog.2016.07.048

Observational Study

Use of antimüllerian hormone to predict the menopausal transition in HIV-infected women

Rebecca Scherzer et al. Am J Obstet Gynecol. 2017 Jan.

. 2017 Jan;216(1):46.e1-46.e11.

doi: 10.1016/j.ajog.2016.07.048. Epub 2016 Jul 26.

Authors

Rebecca Scherzer¹, Ruth M Greenblatt², Zaher O Merhi³, Seble Kassaye⁴, Geralyn Lambert-Messerlian⁵, Pauline M Maki⁶, Kerry Murphy⁷, Roksana Karim⁸, Peter Bacchetti⁹

Affiliations

¹ Department of Medicine, University of California, San Francisco, San Francisco, CA; San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA.
² Department of Medicine, University of California, San Francisco, San Francisco, CA; Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA. Electronic address: ruth.greenblatt@ucsf.edu.
³ Department of Obstetrics and Gynecology, Division of Reproductive Biology, New York University School of Medicine, New York, NY.
⁴ Department of Infectious Diseases, Georgetown University Medical Center, Washington, DC.
⁵ Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Providence, RI.
⁶ Departments of Psychiatry and Psychology, College of Medicine, University of Illinois at Chicago, Chicago, IL.
⁷ Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
⁸ University of Southern California, Los Angeles, CA.
⁹ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.

PMID: 27473002
PMCID: PMC5182170
DOI: 10.1016/j.ajog.2016.07.048

Abstract

Background: HIV infection has been associated with early menopausal onset, which may have adverse long-term health consequences. Antimüllerian hormone, a biomarker of ovarian reserve and gonadal aging, is reduced in HIV-infected women.

Objective: We sought to assess the relationship of antimüllerian hormone to age of menopause onset in HIV-infected women.

Study design: We used antimüllerian hormone levels measured in plasma in 2461 HIV-infected participants from the Women's Interagency HIV Study to model the age at final menstrual period. Multivariable normal mixture models for censored data were used to identify factors associated with age at final menstrual period.

Results: Higher antimüllerian hormone at age 40 years was associated with later age at final menstrual period, even after multivariable adjustment for smoking, CD4 cell count, plasma HIV RNA, hepatitis C infection, and history of clinical AIDS. Each doubling of antimüllerian hormone was associated with a 1.5-year increase in the age at final menstrual period. Median age at final menstrual period ranged from 45 years for those in the 10th percentile of antimüllerian hormone to 52 years for those in the 90th percentile. Other factors independently associated with earlier age at final menstrual period included smoking, hepatitis C infection, higher HIV RNA levels, and history of clinical AIDS.

Conclusion: Antimüllerian hormone is highly predictive of age at final menstrual period in HIV-infected women. Measuring antimüllerian hormone in HIV-infected women may enable clinicians to predict risk of early menopause, and potentially implement individualized treatment plans to prevent menopause-related comorbidities and to aid in interpretation of symptoms.

Keywords: AIDS; HIV; antimüllerian hormone; hepatitis C virus infection; menopause; ovarian reserve; viremia.

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Conflict of interest statement

The remaining authors report no conflict of interest.

Figures

**FIGURE. Predicted age at final menstrual period by AMH at age 40**
Estimates are from multivariable-adjusted models provided in Table 3. Vertical reference line denotes median plasma antimüllerian hormone (AMH) level at age 40 years in this cohort. *FMP*, final menstrual period.

See this image and copyright information in PMC

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References

1. Calvet GA, Grinsztejn BG, Quintana Mde S, et al. Predictors of early menopause in HIV-infected women: a prospective cohort study. Am J Obstet Gynecol. 2015;212:765.e1–13. - PubMed
1. de Pommerol M, Hessamfar M, Lawson-Ayayi S, et al. Menopause and HIV infection: age at onset and associated factors, ANRS CO3 Aquitaine cohort. Int J STD AIDS. 2011;22:67–72. - PubMed
1. Schoenbaum EE, Hartel D, Lo Y, et al. HIV infection, drug use, and onset of natural menopause. Clin Infect Dis. 2005;41:1517–24. - PubMed
1. Centers for Disease Control. Diagnoses of HIV infectione–United States and dependent arease–2013. HIV surveillance report. 2014 Available at: http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed October 06, 2016.
1. Kaiser Family Foundation. The global HIV/AIDS epidemic. 2015 Available at: http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/. Accessed November 25, 2015.

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[1] Calvet GA, Grinsztejn BG, Quintana Mde S, et al. Predictors of early menopause in HIV-infected women: a prospective cohort study. Am J Obstet Gynecol. 2015;212:765.e1–13. - PubMed

[2] Calvet GA, Grinsztejn BG, Quintana Mde S, et al. Predictors of early menopause in HIV-infected women: a prospective cohort study. Am J Obstet Gynecol. 2015;212:765.e1–13. - PubMed

[3] de Pommerol M, Hessamfar M, Lawson-Ayayi S, et al. Menopause and HIV infection: age at onset and associated factors, ANRS CO3 Aquitaine cohort. Int J STD AIDS. 2011;22:67–72. - PubMed

[4] de Pommerol M, Hessamfar M, Lawson-Ayayi S, et al. Menopause and HIV infection: age at onset and associated factors, ANRS CO3 Aquitaine cohort. Int J STD AIDS. 2011;22:67–72. - PubMed

[5] Schoenbaum EE, Hartel D, Lo Y, et al. HIV infection, drug use, and onset of natural menopause. Clin Infect Dis. 2005;41:1517–24. - PubMed

[6] Schoenbaum EE, Hartel D, Lo Y, et al. HIV infection, drug use, and onset of natural menopause. Clin Infect Dis. 2005;41:1517–24. - PubMed

[7] Centers for Disease Control. Diagnoses of HIV infectione–United States and dependent arease–2013. HIV surveillance report. 2014 Available at: http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed October 06, 2016.

[8] Centers for Disease Control. Diagnoses of HIV infectione–United States and dependent arease–2013. HIV surveillance report. 2014 Available at: http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed October 06, 2016.

[9] Kaiser Family Foundation. The global HIV/AIDS epidemic. 2015 Available at: http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/. Accessed November 25, 2015.

[10] Kaiser Family Foundation. The global HIV/AIDS epidemic. 2015 Available at: http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/. Accessed November 25, 2015.

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Use of antimüllerian hormone to predict the menopausal transition in HIV-infected women

Affiliations

Use of antimüllerian hormone to predict the menopausal transition in HIV-infected women

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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Medical

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