Human immunodeficiency virus and menopause

Kanapathipillai, Rupa; Hickey, Martha; Giles, Michelle

doi:10.1097/gme.0b013e318282aa57

Cited by 30 publications

(22 citation statements)

References 108 publications

(84 reference statements)

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“…21 For HIV-infected women, such debut of menopausal stage may occur earlier (i.e., accelerated aging) and menopausal symptoms such as psychological symptoms, sleep problems, and vasomotor symptoms may be more severe (i.e., accentuated aging) compared to uninfected women; 22–25 yet, in one cross-sectional study, the severity of menopausal symptoms in each of the five categories (mood, sleep, vasomotor, somatic, vaginal) was similar in HIV-infected women and uninfected women overall and as a function of menopausal stage. In adjusted analyses, HIV-infected women remained at increased odds on persistent night sweats only.…”

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confidence: 99%

Aging and Neurocognitive Functioning in HIV-Infected Women: a Review of the Literature Involving the Women’s Interagency HIV Study

et al. 2016

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HIV-infected women may be particularly vulnerable to certain types of neurocognitive impairments which may be exacerbated by aging and other predictors. Within the context of cognitive reserve, this article examines issues surrounding women as they age with HIV. For this, a review of 12 recent studies (2013–2016) using data from the Women’s Interagency HIV Study (WIHS), the largest cohort study comparing HIV-infected and demographically-matched uninfected women, is presented that specifically examine neurocognition. In general, HIV-infected women are more vulnerable to developing neurocognitive impairments than uninfected women; other factors that may contribute to these neurocognitive impairments include recent illicit drug use, reading level (educational quality/cognitive reserve), stress, PTSD, insulin resistance, liver fibrosis, and age. Surprisingly, when examined in some analyses, age X HIV interactions were not observed to impact neurocognitive performance, findings largely consistent in the literature; however, longitudinal analyses of these data have yet to be performed which may yield future insights of how cognitive reserve may be compromised over time. Yet, with insulin resistance, liver fibrosis, stress, and other known predictors of poorer neurocognition also occurring more with advanced age, in time the synergistic effect of age and HIV may be more robust and observable as this population ages.

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confidence: 99%

Aging and Neurocognitive Functioning in HIV-Infected Women: a Review of the Literature Involving the Women’s Interagency HIV Study

et al. 2016

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“…In 2011, 45–49 year olds were the largest group of women estimated to be living with HIV in the United States (Imai et al, 2013). The effects of infection on the climacteric are under-investigated; however, recent studies suggest that HIV-afflicted women transition to post-menopause sooner and experience greater symptomology than non-afflicted controls (Boonyanurak et al, 2012; Fan et al, 2008; Kanapathipillai et al 2013; Rubin et al, 2014). Moreover, antiretroviral therapies may contribute to the worsening of some post-menopausal symptoms (Kanapathipillai et al 2013).…”

Section: Discussionmentioning

confidence: 99%

“…The effects of infection on the climacteric are under-investigated; however, recent studies suggest that HIV-afflicted women transition to post-menopause sooner and experience greater symptomology than non-afflicted controls (Boonyanurak et al, 2012; Fan et al, 2008; Kanapathipillai et al 2013; Rubin et al, 2014). Moreover, antiretroviral therapies may contribute to the worsening of some post-menopausal symptoms (Kanapathipillai et al 2013). Moreover, HIV-infected premenopausal women have been found to have lower circulating E 2 compared to uninfected controls (Karim et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Progesterone protects normative anxiety-like responding among ovariectomized female mice that conditionally express the HIV-1 regulatory protein, Tat, in the CNS

Paris

Fenwick

McLaughlin

2014

Hormones and Behavior

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Increased anxiety is co-morbid with human immunodeficiency virus (HIV) infection. Actions of the neurotoxic HIV-1 regulatory protein, Tat, may contribute to affective dysfunction. We hypothesized that Tat expression would increase anxiety-like behavior of female GT-tg bigenic mice that express HIV-1 Tat protein in the brain in a doxycycline-dependent manner. Furthermore, given reports that HIV-induced anxiety may occur at lower rates among women, and that the neurotoxic effects of Tat are ameliorated by sex steroids in vitro, we hypothesized that 17β-estradiol and/or progesterone would ameliorate Tat-induced anxiety-like effects. Among naturally-cycling proestrous and diestrous mice, Tat-induction via 7 days of doxycycline treatment significantly increased anxiety-like responding in an open field, elevated plus maze and a marble-burying task, compared to treatment with saline. Proestrous mice demonstrated less anxiety-like behavior than diestrous mice in the open field and elevated plus maze, but these effects did not significantly interact with Tat-induction. Among ovariectomized mice, doxycycline-induced Tat protein significantly increased anxiety-like behavior in an elevated plus maze and a marble burying task compared to saline-treated mice, but not an open field (where anxiety-like responding was already maximal). Co-administration of progesterone (4 mg/kg), but not 17β-estradiol (0.09 mg/kg), with doxycycline significantly ameliorated anxiety-like responding in the elevated plus maze and marble burying tasks. When administered together, 17β-estradiol partially antagonized the protective effects of progesterone on Tat-induced anxiety-like behavior. These findings support evidence of steroid-protection over HIV-1 proteins, and extend them by demonstrating the protective capacity of progesterone on Tat-induced anxiety-like behavior of ovariectomized female mice.

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“…Despite a growing literature on normative changes in cognition, depression, and anxiety associated with the menopausal transition, little is known about menopause in HIV-infected women, particularly with regard to cognitive function. Previous cross-sectional studies indicate that compared to HIV-uninfected women, HIV-infected women report more menopausal symptoms including vasomotor, sleep disturbances, and psychological symptoms 2-5 and may have an earlier age at menopause 3, 4, 6, 7 . In the United States, smoking, low socioeconomic status, and drug use are relatively common among women with HIV; these are all factors associated with depression, anxiety, and vasomotor symptoms 8, 9 .…”

Section: Introductionmentioning

confidence: 99%

Investigation of menopausal stage and symptoms on cognition in human immunodeficiency virus–infected women

et al. 2014

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Objective: We evaluated the separate and interactive associations of menopausal stage, menopausal symptoms, and HIV infection on cognition. We hypothesized that HIV-infected, perimenopausal women would show the greatest cognitive difficulties and that menopausal symptoms would be inversely associated with cognition. Methods:This cross-sectional study included 708 HIV-infected and 278 HIV-uninfected, pre-, peri-, or postmenopausal women (64% African-American; median age 44 years) from the Women's Interagency HIV Study. Participants completed tests of verbal learning and memory,

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Human immunodeficiency virus and menopause

Cited by 30 publications

References 108 publications

Aging and Neurocognitive Functioning in HIV-Infected Women: a Review of the Literature Involving the Women’s Interagency HIV Study

Aging and Neurocognitive Functioning in HIV-Infected Women: a Review of the Literature Involving the Women’s Interagency HIV Study

Progesterone protects normative anxiety-like responding among ovariectomized female mice that conditionally express the HIV-1 regulatory protein, Tat, in the CNS

Investigation of menopausal stage and symptoms on cognition in human immunodeficiency virus–infected women

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