HIV and amenorrhea: a meta-analysis.

Area of Science:

• Reproductive Health
• Infectious Diseases
• Epidemiology

Background:

• Conflicting literature exists regarding the association between Human Immunodeficiency Virus (HIV) and amenorrhea.
• Amenorrhea, defined as the absence of menstruation for 3 months or longer, is a significant reproductive health concern.

Purpose of the Study:

• To conduct a meta-analysis of landmark studies to summarize and clarify the clinical association between HIV and amenorrhea.
• To assess the prevalence of amenorrhea in premenopausal women living with HIV (WLWH).

Main Methods:

• A systematic search of Ovid Medline and Embase was performed to identify controlled matched observational studies.
• Six studies published between 1996 and 2010, involving 8925 women (6570 WLWH), were included in the meta-analysis.
• A random-effects model was utilized, with heterogeneity assessed using the I2 statistic.

Main Results:

• A significant association was found between HIV status and amenorrhea (OR 1.68, P value 0.0001) with no evidence of heterogeneity (I2: 0.0%).
• Substance use, smoking, and socioeconomic status did not significantly differ between WLWH and controls in most studies.
• Amenorrhea in the context of low body mass index (BMI) was more frequent in WLWH compared to controls.

Conclusions:

• This meta-analysis indicates an increased prevalence of menstrual disturbances, specifically amenorrhea, in WLWH.
• The association between HIV and amenorrhea appears independent of substance use and socioeconomic status, but may be related to low BMI.
• Routine assessment of reproductive health, including the last menstrual period, is crucial for women, particularly those living with HIV.