Low genitourinary tract risks in women living with the human immunodeficiency virus.
Faustino Ramón Pérez-LópezAna María Fernández-AlonsoEdward Mezones-HolguinPedro Vieira BaptistaPublished in: Climacteric : the journal of the International Menopause Society (2023)
This review analyzes the clinical associations between specific low genitourinary tract clinical circumstances in perimenopausal and postmenopausal women living with human immunodeficiency virus (WLHIV). Modern antiretroviral therapy (ART) improves survival and reduces opportunistic infections and HIV transmission. Despite appropriate ART, WLHIV may display menstrual dysfunction, risk of early menopause, vaginal microbiome alterations, vaginal dryness, dyspareunia, vasomotor symptoms and low sexual function as compared to women without the infection. They have increased risks of intraepithelial and invasive cervical, vaginal and vulvar cancers. The reduced immunity capacity may also increase the risk of urinary tract infections, side-effects or toxicity of ARTs, and opportunistic infections. Menstrual dysfunction and early menopause may contribute to the early onset of vascular atherosclerosis and plaque formation, and increased osteoporosis risks requiring specific early interventions. On the other hand, the association between being postmenopausal and having a low sexual function is significant and related to low adherence to ART. WLHIV deserve a specific approach to manage different low genitourinary risks and complications related to hormone dysfunction and early menopause.
Keyphrases
- human immunodeficiency virus
- antiretroviral therapy
- postmenopausal women
- hiv infected
- hiv positive
- bone mineral density
- hepatitis c virus
- hiv aids
- hiv infected patients
- early onset
- oxidative stress
- polycystic ovary syndrome
- human health
- high grade
- cardiovascular disease
- urinary tract infection
- young adults
- metabolic syndrome
- early stage
- radiation therapy
- adipose tissue
- risk factors
- sleep quality