Ezechi Oliver C, Jogo Andrea, Gab-Okafor Chidinma, Onwujekwe Dan I, Ezeobi Paschal M, Gbajabiamila Titi, Adu Rosemary A, Audu Rosemary A, Musa Adesola Z, Salu Olumuyiwa B, Meschack Emily, Herbertson Ebiere, Odunukwe Nkiru, Idigbe Oni E
Sexual and Reproductive Health Research Unit, Clinical Sciences Division, Nigerian Institute of Medical Research, Lagos, Nigeria. oezechi@ yahoo.co.uk
J Obstet Gynaecol Res. 2010 Oct;36(5):1053-8. doi: 10.1111/j.1447-0756.2010.01253.x.
The aim of this study was to determine the prevalence, pattern and determinants of menstrual abnormalities in HIV-positive Nigerian women.
A cross-sectional study was carried out involving 3473 (2549 HIV-seropositive and 924 seronegative) consecutive and consenting women seen at the HIV treatment centers at the Nigerian Institute of Medical Research, Lagos and the Federal Medical Centre, Markurdi.
The sociodemographic characteristics of the two groups were comparable, except for body mass index (BMI): the HIV-negative women (28.1 ± 8.1) had statistically significantly (P < 0.005) higher BMI compared to the HIV-positive women (21.9 ± 7.5). Menstrual abnormalities were significantly more common in women living with HIV/AIDS (29.1%) compared to the HIV-negative (18.9%) women (P < 0.001). The proportions of women in the two groups with intermenstrual bleeding, menorrhagia, hypermenorrhea, and postcoital bleeding were similar (P > 0.005), however amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea were more common in the HIV-positive women (P < 0.02). Primary dysmenorrhea was less common in HIV-positive women (P < 0.03). Among the HIV-positive women, menstrual dysfunction was more common in women living with HIV/AIDS with opportunistic infections, CD4 count < 200, not undertaking therapy, symptomatic disease and BMI < 20. However, after controlling for cofounders, only CD4 < 200 (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.2-9.7), BMI < 20 (OR, 2.4; 95%CI, 1.3-3.5) and not taking antiretroviral drugs (OR, 2.05; CI, 1.7-6.5) were associated with amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea.
HIV-positive women in this study experienced more menstrual abnormalities of amenorrhea, oligomenorrhea, and irregular periods compared to the HIV-negative controls. HIV-positive women with CD4 count < 200, BMI < 20 and who do not take antiretroviral drugs are at the greatest risk.
本研究旨在确定尼日利亚感染艾滋病毒女性月经异常的患病率、模式及决定因素。
开展了一项横断面研究，纳入了在拉各斯的尼日利亚医学研究所和马库尔迪联邦医疗中心的艾滋病毒治疗中心连续就诊并同意参与的3473名女性（2549名艾滋病毒血清阳性和924名血清阴性）。
除体重指数（BMI）外，两组的社会人口学特征具有可比性：艾滋病毒阴性女性（28.1±8.1）的BMI在统计学上显著高于艾滋病毒阳性女性（21.9±7.5）（P<0.005）。与艾滋病毒阴性女性（18.9%）相比，艾滋病毒/艾滋病女性月经异常更为常见（29.1%）（P<0.001）。两组间经间期出血、月经过多、月经量过多和性交后出血的女性比例相似（P>0.005），然而闭经、月经过少、月经不规律和继发性痛经在艾滋病毒阳性女性中更为常见（P<0.02）。原发性痛经在艾滋病毒阳性女性中较少见（P<0.03）。在艾滋病毒阳性女性中，月经功能障碍在患有机会性感染、CD4计数<200、未接受治疗、有症状疾病且BMI<20的艾滋病毒/艾滋病女性中更为常见。然而，在控制混杂因素后，只有CD4<200（比值比[OR]，3.65；95%置信区间[CI]，1.2 - 9.7）、BMI<20（OR，2.4；95%CI，1.3 - 3.5）和未服用抗逆转录病毒药物（OR，2.05；CI，1.7 - 6.5）与闭经、月经过少、月经不规律和继发性痛经相关。
与艾滋病毒阴性对照相比，本研究中的艾滋病毒阳性女性闭经、月经过少和月经不规律这些月经异常更为常见。CD4计数<200、BMI<20且未服用抗逆转录病毒药物的艾滋病毒阳性女性风险最大。
