不同特征HIV阳性育龄女性抗苗勒氏管激素水平

Anti-Müllerian hormone levels in HIV-positive reproductive women with different characteristics

目的比较不同特征HIV阳性育龄女性抗苗勒氏管激素(AMH)水平,探讨HIV感染对女性卵巢功能的影响。方法检测不同特征的HIV阳性与HIV阴性育龄女性AMH水平,比较其差异。结果共715例HIV阳性育龄妇女(HIV阳性组)纳入研究,以同期接受体检的152例HIV阴性妇女作为对照(HIV阴性组),两组年龄构成差异无统计学意义(P>0.05)。HIV阳性18~30岁组和31~40岁组的AMH水平分别为5.8(3.2,10.6)ng/mL和3.5(1.8,7.0)ng/mL,前者明显高于后者(Z=-6.27,P=0.00);HIV阴性组18~30岁组和31~40岁组的AMH水平分别为7.4(4.2,10.0)ng/mL与3.8(2.4,6.4)ng/mL,前者也明显高于后者(Z=-4.78,P=0.00)。但HIV阳性和阴性受试者在同一年龄组的AMH水平比较差异无统计学意义(Z=-1.39,P=0.16;Z=-0.61,P=0.54)。同一年龄组的HIV阳性育龄妇女AMH水平,在是否接受ART,不同ART时长,不同ART方案,当前和治疗前HIV-1 RNA水平、CD4细胞计数和CD4/CD8比值间未见差异有统计学意义(P均>0.05)。结论不同年龄组育龄女性AMH水平有明显差别,但未见HIV感染及其他特征对AMH水平的影响,有待前瞻性研究进一步验证。

Objective To compare the serum anti-Mullerian hormone(AMH)level in HIV-positive reproductive women with different characteristics and explore the impact of HIV infection on ovarian function.Methods The serum AMH levels of reproductive age females,including HIV-positive and HIV-negative women,with 18-40 years old,without the gynecological disease,opportunistic infection,and tumor were tested.Meanwhile,these hormone levels in different subgroups classified by various factors were compared.Results A total of 715 HIV-positive healthy women of childbearing age(HIV positive group)were included in the study.152 HIV-negative healthy women of childbearing age who received a physical examination in the same period were taken as the control group(HIV negative group).The group was divided into two subgroups at the age of 30,including age stratification of 18-30 and 30-40.There was no statistical difference in the age between different subgroups(P>0.05).The AMH levels in HIV positive subgroups aged 18-30 and 31-40 were 5.8(3.2,10.6)ng/mL and 3.5(1.8,7.0)ng/mL,respectively,the former was significantly higher than the latter(z=-6.27,P=0.00);the AMH levels of HIV negative subgroups aged 18-30 and 31-40 were 7.4(4.2,10.0)ng/mL and 3.8(2.4,6.4)ng/mL,the former was also significantly higher than the latter(z=-4.78,P=0.00).However,there was no significant difference in AMH level between HIV positive and HIV negative subjects(z=-1.39,P=0.16;Z=-0.61,P=0.54).Moreover,in the same age subgroup,the serum AMH level did not change significantly regardless of the ART history,ART duration and regimen,HIV-1 RNA level,baseline CD4+count and CD4+/CD8+ratio,current CD4+count,and CD4+/CD8+ratio after ART(all P>0.05).Conclusion This study suggests that HIV infection and its different characteristics have no significant effect on AMH level in women of childbearing age,which needs to be further verified by prospective studies.