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. 2023 Mar;24(3):247-259.
doi: 10.1111/hiv.13364. Epub 2022 Aug 2.

Markers of ovarian reserve in women living with HIV: A systematic review

Elizabeth M King  1   2 , Shayda A Swann  1   3 , Melanie C M Murray  1   2   4
Affiliations
Free article

Markers of ovarian reserve in women living with HIV: A systematic review

Elizabeth M King et al. HIV Med. 2023 Mar.
Free article

Abstract

Background: Anti-Mullerian hormone (AMH) levels indicate ovarian reserve and are predictive of reproductive aging. Studies evaluating AMH levels in women with HIV have produced conflicting results, and reasons for inter-study differences have not been assessed. To understand reproductive aging in HIV, we conducted a systematic review of ovarian reserve among women with HIV.

Methods: We searched Ovid MEDLINE, Ovid EMBASE, and CAB Direct for studies including AMH in reproductive-aged women with HIV. Two reviewers used the Newcastle-Ottawa scale to assess the quality of extracted data.

Results: Of the 315 reports screened, ten met the inclusion criteria. Studies were conducted across seven countries and included 3673 women with HIV and 2342 HIV-negative women in the comparison group. Ethnic distribution, combination antiretroviral therapy coverage, and viral load suppression varied considerably across studies. Nine of the ten reviewed studies reported lower unadjusted AMH levels in women with HIV than in those without HIV; however, in studies that adjusted for confounders (n = 4), only two showed an association between HIV and AMH. Low CD4 count and high viral load correlated with low AMH in the two largest studies. Other studies found that opioid use and elevated inflammatory markers were associated with low AMH. Study quality varied considerably, and many were of low quality (n = 6).

Conclusion: Current evidence is inconclusive about the relationship between HIV and AMH, although studies suggest a trend toward lower AMH among women with HIV. Future studies that adjust for HIV-related factors, inflammatory markers, and substance use are needed in the era of contemporary HIV care to confirm the association between HIV and reduced ovarian reserve and establish its underlying cause.

Keywords: HIV; Mullerian inhibiting substance; anti-Mullerian hormone; ovarian reserve; reproductive aging.

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References

REFERENCES

    1. Donaldson MA, Campbell AR, Albert AY, et al. Comorbidity and polypharmacy among women living with HIV in British Columbia. Aids. 12. 2019;33(15):2317-2326. doi:10.1097/QAD.0000000000002353
    1. Lazarus JV, Safreed-Harmon K, Barton SE, et al. Beyond viral suppression of HIV - the new quality of life frontier. BMC Med. 2016;14(1):94. doi:10.1186/s12916-016-0640-4
    1. Van Ommen C, King E, Murray M. Age at menopause in women living with HIV: a systematic review. Menopause. 2021;28(12):1428-1436.
    1. Andany N, Kaida A, de Pokomandy A, et al. Prevalence and correlates of early-onset menopause among women living with HIV in Canada. Menopause. 2020;27(1):66-75. doi:10.1097/GME.0000000000001423
    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.

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