Chirgwin K D, Feldman J, Muneyyirci-Delale O, Landesman S, Minkoff H
Department of Medicine, State University of New York, Health Science Center at Brooklyn 11203, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Aug 15;12(5):489-94. doi: 10.1097/00042560-199608150-00008.
To assess whether HIV infection is associated with menstrual abnormalities in HIV-infected women without AIDS, we evaluated 248 premenopausal HIV-infected women without AIDS and 82 HIV-negative women. Detailed medical, drug use, and menstrual histories (using menstrual calendars) were obtained. Complete physical and pelvic examinations and CD4 counts were performed. HIV-infected women were more likely to experience intervals > 6 weeks without menstrual bleeding [8 vs. 0%, odds ratio (OR) = 10.8, 95% confidence interval (CI) 1.8-1,000) and amenorrhea > 3 months (5 vs. 0%, OR = 7.1, 95% CI 1.1-1,000) (after adjustment for drug use, age, and race). Premenstrual breast swelling (p = 0.01), tenderness (p = 0.01), and dysmenorrhea (p = 0.04) were less common in HIV-infected women. There were no differences in intermenstrual bleeding or irregular menstrual cycles. Among HIV-infected women, only a past history of substance abuse was significantly associated with menstrual irregularities in a logistic regression model adjusting for age, current and past drug use, alcohol use, cigarette smoking, CD4 count, and category B conditions [1993 Centers for Disease Control (CDC) classification system]. The increase in amenorrhea (> 3 months) and in menstrual cycle intervals > 6 weeks and the lower rates of premenstrual breast symptoms in HIV-positive women suggest the possibility of disturbances in menstrual function that do not appear to be attributable to clinically apparent secondary complications of HIV. Changes in menstrual function were also significantly associated with a past history of, but not current, substance abuse, suggesting the possibility that socioeconomic factors rather than biologic effects of drugs may be responsible.
为评估在未患艾滋病的HIV感染女性中，HIV感染是否与月经异常相关，我们对248名未患艾滋病的绝经前HIV感染女性和82名HIV阴性女性进行了评估。获取了详细的医疗、用药及月经史（使用月经日历）。进行了全面的体格和盆腔检查以及CD4计数。HIV感染女性更有可能经历月经出血间隔>6周[8% vs. 0%，优势比（OR）=10.8，95%置信区间（CI）1.8 - 1,000]以及闭经>3个月（5% vs. 0%，OR = 7.1，95% CI 1.1 - 1,000）（在对用药、年龄和种族进行调整后）。经前期乳房胀痛（p = 0.01）、触痛（p = 0.01）和痛经（p = 0.04）在HIV感染女性中较少见。月经间期出血或月经周期不规律方面无差异。在HIV感染女性中，在对年龄、当前和既往用药、饮酒、吸烟、CD4计数以及B类疾病[1993年疾病控制中心（CDC）分类系统]进行校正的逻辑回归模型中，只有既往药物滥用史与月经不规律显著相关。HIV阳性女性闭经（>3个月）、月经周期间隔>6周的增加以及经前期乳房症状发生率较低表明，月经功能紊乱有可能并非由HIV临床上明显的继发并发症所致。月经功能变化也与既往而非当前的药物滥用史显著相关，这表明社会经济因素而非药物的生物学效应可能是原因所在。
