Department of Medicine, University of California, San Francisco, CA, 94143, USA.
Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA, 94121, USA.
Curr HIV/AIDS Rep. 2022 Feb;19(1):133-139. doi: 10.1007/s11904-021-00594-7. Epub 2021 Dec 8.
To describe research advances in the menopausal transition (MT) and its effects on HIV replication, immune activation, and metabolic parameters in women living with HIV (WLWH).
Physiologic changes due to declines in ovarian reserve characterize the MT. Evidence suggests that estrogen depletion influences HIV replication and the latent reservoir. Changes in markers of immune activation, waist circumference, and neurocognition, independent of chronologic age, occur before the final menstrual period (FMP). HIV effects on gut microbial translocation and adipose tissue, as well as health disparities in WLWH may contribute. Improved biomarker sensitivity to predict FMP provides opportunities to study MT in WLWH. Research is needed to determine the effects of MT and HIV on virologic and clinical outcomes, using accurate assessments to predict the FMP and menopausal stages. These findings could inform the timing of interventions to prevent early onset of adverse outcomes in WLWH.
描述绝经过渡（MT）的研究进展，及其对 HIV 复制、免疫激活和 HIV 感染者（WLWH）代谢参数的影响。
卵巢储备减少导致的生理变化特征是 MT。有证据表明，雌激素耗竭会影响 HIV 复制和潜伏库。在最后一次月经（FMP）之前，就会出现免疫激活标志物、腰围和神经认知的变化，而与年龄无关。HIV 对肠道微生物易位和脂肪组织的影响，以及 WLWH 中的健康差异可能起作用。改善生物标志物的敏感性以预测 FMP 为研究 WLWH 的 MT 提供了机会。需要研究 MT 和 HIV 对病毒学和临床结果的影响，使用准确的评估来预测 FMP 和绝经阶段。这些发现可以为干预措施的时机提供信息，以防止 WLWH 中不良后果的过早发生。
