HIV This Week

Conde DM, Silva ET, Amaral WN, Finotti MF, Ferreira RG, Costa-Paiva L, Pinto-Neto AM. HIV, reproductive aging, and health implications in women: a literature review. Menopause 2009; 16(1) [Epub ahead of print]

Infection by the human immunodeficiency virus (HIV) is increasing among women. After the advent of highly active antiretroviral therapy (HAART), a decrease occurred in the mortality rate, which now seems to have stabilized. One of the consequences of this current situation is that more and more HIV-infected women are now reaching menopause. Therefore, factors often investigated in seronegative women need to be evaluated in middle-aged, HIV-positive women. In midlife, HIV-positive women will experience the onset of menopause, while concomitantly they may also be affected by metabolic complications related to the HIV infection and to HAART. This literature review was therefore carried out to identify studies dealing with conditions related to middle-aged women with HIV with the aim of providing data on age at menopause, menopausal symptoms, reproductive hormones, cognitive function, bone mineral density, cardiovascular disease, and lipid and glucose metabolism in middle-aged women with HIV and discussing these issues. Some of these factors may be aggravated by the HIV infection and by HAART. The prevention and treatment of these conditions in middle-aged, HIV-positive women are discussed in the light of current knowledge.

Editors’ note: This excellent review from Brazil is timely because the number of middle-aged women living with HIV is increasing. This is in part the result of improved access to life-prolonging antiretroviral treatment and in part due to biological and social vulnerability to HIV acquisition during this phase of women’s lives. The review highlights the preventive and therapeutic measures needed to minimise the long-term complications of HIV and its treatment as the ovaries fail, as well as the importance of further studies to determine optimal therapies for the conditions experienced by middle-aged HIV-positive women.