Effect of HIV‐1 infection and increasing immunosuppression on menstrual function

AIM: The aim of this study was to determine the prevalence pattern and determinants of menstrual abnormalities in HIV-positive Nigerian women. METHODS: 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. RESULTS: 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) 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. CONCLUSION: 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.