Department of Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
Maturitas. 2009 Nov 20;64(3):160-4. doi: 10.1016/j.maturitas.2009.09.001. Epub 2009 Sep 23.
With the advent of highly active antiretroviral agents, women with HIV infection can expect to live longer than ever before. This increased survival has led to concerns about the long-term implications of HIV disease and its treatment. Women with HIV infection appear to lose ovarian function earlier in life than women without HIV infection. They also have evidence of reduced bone mineral density and increased cardiovascular risk. Moreover, many of these increases in risk factors are present even prior to the menopausal transition. All of these risks, present at midlife, augur poorly for future health and describe a substantially increased burden of disease likely to accrue to HIV-infected women as they enter older age groups. Further compounding the adversity faced by the HIV infected, the demographics of women most vulnerable to this disease include adverse social and economic influences, both of which worsen their long-term prognosis. For example, drug use and poverty are related to more severe menopausal symptoms and chronic stress is related to worse psychological and cardiovascular risk. An understanding of how menopause interacts with HIV infection is therefore most important to alert the clinician to perform surveillance for common health problems in postmenopausal women, and to address directly and appropriately symptomatology during the menopausal transition.
随着高效抗逆转录病毒药物的出现，HIV 感染者的预期寿命比以往任何时候都要长。这种生存时间的延长导致了人们对 HIV 疾病及其治疗的长期影响的担忧。与未感染 HIV 的女性相比，HIV 感染女性的卵巢功能似乎更早衰退。她们还存在骨密度降低和心血管风险增加的证据。此外，即使在绝经过渡期之前，许多这些危险因素就已经存在。所有这些在中年出现的风险，预示着未来的健康状况不佳，并描述了随着 HIV 感染女性进入老年群体，她们可能会面临更多的疾病负担。进一步加剧 HIV 感染者面临的困境的是，最容易感染这种疾病的女性的人口统计学特征包括不利的社会和经济影响，这两者都使她们的长期预后恶化。例如，吸毒和贫困与更严重的更年期症状有关，而慢性压力与更差的心理和心血管风险有关。因此，了解绝经如何与 HIV 感染相互作用对于提醒临床医生对绝经后妇女的常见健康问题进行监测以及在绝经过渡期间直接和适当地处理症状非常重要。
