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Clinical Summary

HIV ups early menopause risk, especially in women with hepatitis C

Takeaway

  • Women living with HIV (WLHIV) transition through menopause earlier than the general population.
  • Risk appears to increase ≥2-fold among WLHIV with hepatitis C (HEP-C) coinfection, recreational drug use, and/or less than high-school education.

Why this matters

  • Screen WLHIV for early comorbidities.
  • Monitor for early menopause onset, discuss risk associated with premature, early menopause, including bone and cardiovascular issues, as well as preventive actions.

Key results

  • Among 1422 women completing initial questionnaire, 229 were postmenopausal, reported age at menopause.
  • Excluding women reporting induced menopause (15.3%, n=35), median age at menopause was 49 (interquartile range [IQR], 45-52) years.
  • 22.7% (95% CI, 16.7%-28.6%) reported menopause onset <45 years, 14.9% (95% CI, 9.9%-20.0%) reported onset 40 to <45 years, 7.7% (95% CI, 3.9%-11.5%) reported onset <40 years.
  • Factors linked to early menopause <45 years: having less than high-school education (OR, 3.11; 95% CI, 1.35-7.19).
  • HEP-C coinfection trended toward increased risk (OR, 1.96; 95% CI, 0.93-4.14).

Study design

  • Cross-sectional analysis of data from Canadian HIV Women’s Sexual and Reproductive Health Cohort Study to determine average age at menopause, early (ages 40-45 years), premature menopause (<40 years), correlates among HIV-positive women.
  • Funding: Canadian Institutes of Health Research; others.

Limitations

  • Cross-sectional.
  • Self-report bias.
  • Small sample size.
  • Limited generalisability.

References


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