American journal of obstetrics and gynecology 2016 7 26() pii 10.1016/j.ajog.2016.07.048
HIV infection has been associated with early menopausal onset, which may have adverse long-term health consequences. Anti-Müllerian hormone (AMH), a biomarker of ovarian reserve and gonadal aging, is reduced in HIV-infected women.
We sought to assess the relationship of AMH to age of menopause onset in HIV-infected women.
We used AMH levels measured in plasma in 2,461 HIV-infected participants from the Women’s Interagency HIV Study (WIHS) to model the age at final menstrual period (FMP). Multivariable normal mixture models for censored data were used to identify factors associated with age at FMP.
Higher AMH at age 40 was associated with later age at FMP, even after multivariable adjustment for smoking, CD4 cell count, plasma HIV RNA, hepatitis C infection, and history of clinical AIDS. Each doubling of AMH was associated with a 1.5-year increase in the age at FMP. Median age at FMP ranged from 45 years for those in the 10(th) percentile of AMH to 52 years for those in the 90(th) percentile. Other factors independently associated with earlier age at FMP included smoking, hepatitis C infection, higher HIV RNA levels, and history of clinical AIDS.
AMH is highly predictive of age at final menstrual period in HIV-infected women. Measuring AMH in HIV-infected women may enable clinicians to predict risk of early menopause, and potentially implement individualized treatment plans to prevent menopause-related comorbidities and to aid in interpretation of symptoms.