title: Use of antimüllerian hormone to predict the menopausal transition in HIV-infected women.
abstract: BACKGROUND
  HIV infection has been associated with early menopausal onset, which may have adverse long-term health consequences. Antimüllerian hormone, a biomarker of ovarian reserve and gonadal aging, is reduced in HIV-infected women.
  
  
  OBJECTIVE
  We sought to assess the relationship of antimüllerian hormone to age of menopause onset in HIV-infected women.
  
  
  METHODS
  We used antimüllerian hormone levels measured in plasma in 2461 HIV-infected participants from the Women's Interagency HIV Study to model the age at final menstrual period. Multivariable normal mixture models for censored data were used to identify factors associated with age at final menstrual period.
  
  
  RESULTS
  Higher antimüllerian hormone at age 40 years was associated with later age at final menstrual period, even after multivariable adjustment for smoking, CD4 cell count, plasma HIV RNA, hepatitis C infection, and history of clinical AIDS. Each doubling of antimüllerian hormone was associated with a 1.5-year increase in the age at final menstrual period. Median age at final menstrual period ranged from 45 years for those in the 10th percentile of antimüllerian hormone to 52 years for those in the 90th percentile. Other factors independently associated with earlier age at final menstrual period included smoking, hepatitis C infection, higher HIV RNA levels, and history of clinical AIDS.
  
  
  CONCLUSIONS
  Antimüllerian hormone is highly predictive of age at final menstrual period in HIV-infected women. Measuring antimüllerian hormone 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.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA; San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Scherzer
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA; Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA. Electronic address: ruth.greenblatt@ucsf.edu.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Biology, New York University School of Medicine, New York, NY.
authors.forename: Zaher O
authors.initials: ZO
authors.lastname: Merhi
authors.affiliation: Department of Infectious Diseases, Georgetown University Medical Center, Washington, DC.
authors.forename: Seble
authors.initials: S
authors.lastname: Kassaye
authors.affiliation: Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Providence, RI.
authors.forename: Geralyn
authors.initials: G
authors.lastname: Lambert-Messerlian
authors.affiliation: Departments of Psychiatry and Psychology, College of Medicine, University of Illinois at Chicago, Chicago, IL.
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Maki
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Kerry
authors.initials: K
authors.lastname: Murphy
authors.affiliation: University of Southern California, Los Angeles, CA.
authors.forename: Roksana
authors.initials: R
authors.lastname: Karim
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
authors.forename: Peter
authors.initials: P
authors.lastname: Bacchetti
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000097:blood; D008594:Menopause, Premature / Q000097:blood*; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D019562:Viral Load
chemical_list: D012367:RNA, Viral; D054304:Anti-Mullerian Hormone
keywords: AIDS; HIV; antimüllerian hormone; hepatitis C virus infection; menopause; ovarian reserve; viremia