Metabolic and Psychological Changes Associated With Menopause Among Women With HIV - Full Text View

Purpose

This study will investigate the prevalence and extent of both metabolic and psychosocial changes associated with the menopause transition over 1 year among women with HIV compared to women without HIV of similar age, weight, menstrual status, and ethnic background. It is hypothesized that HIV positive women will demonstrate increased abdominal fat, abnormal cholesterol and blood sugar levels, reduced bone density, and greater psychosocial challenges than HIV negative women during the menopause transition.

Condition
HIV Infections Menopause


Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Metabolic and Psychological Changes Associated With Menopause Among Women With HIV

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS Menopause

U.S. FDA Resources

Further study details as provided by Sara E. Dolan Looby, PhD, ANP-BC, Massachusetts General Hospital:

Primary Outcome Measures:

Bone Mineral Density [ Time Frame: baseline to 12 months ]
Measurement of bone density at the toal body, lumbar spine and total hip

Secondary Outcome Measures:

Body Composition [ Time Frame: baseline to 12 months ]
Total body fat and abdominal fat measurement, and total lean mass measurement
Lipid Levels [ Time Frame: baseline to 12 months ]
Lipid levels include total cholesterol, low density lipoprotein, high density lipoprotein, and triglyceride levels
Glucose Metabolism [ Time Frame: baseline to 12 months ]
Includes fasting glucose and insulin levels
Depression [ Time Frame: baseline to 12 months ]
Depressive symptoms assessed by the Centers for Epidemiologic Studies Depression Scale (CES-D)
Quality of Life [ Time Frame: baseline to 12 months ]
Assessed by the Utian Quality of Life Scale
Vasomotor Symptoms [ Time Frame: Baseline to 12 months ]
Assessed by the Menopause Rating Scale, includes hot flashes, mood, sleep, genitourinary symptoms, and sexual function
Systemic Inflammation (as it relates to cardiovascular risk/body composition changes) [ Time Frame: Baseline to 12 months ]
Assessment of inflammatory biomarkers and cytokines including CRP,IL-6, TNF-α, and PAI-1, as well as adiponectin.

Biospecimen Retention: Samples Without DNA

Whole blood, serum


Enrollment:	66
Study Start Date:	June 2010
Study Completion Date:	May 2013
Primary Completion Date:	May 2013 (Final data collection date for primary outcome measure)

Groups/Cohorts
HIV Postive Women Women living with HIV who meet study eligibility criteria
Healthy Control Subjects Women without HIV who meet study eligibility criteria

Detailed Description:

Treatment with combination antiretroviral therapy (ART) has resulted in substantial improvement in survival among women living with HIV in the United States, many of whom have entered or will soon enter the menopause transition. Significant changes are seen across the menopause transition among women without HIV including increased abdominal fat and waist circumference, reduced muscle mass, and changes in lipids, glucose metabolism and bone density. HIV and potentially ART use have been associated with similar manifestations such as reduced bone density, changes in lipid and glucose metabolism, and body composition, though little is known regarding how the virus may influence or exacerbate such changes across the menopause transition. In addition to metabolic factors, menopause has been associated with changes in mood state, decreased quality of life, and presence of vasomotor symptoms among women without HIV. Psychosocial indices, such as depression and decreased quality of life are common among women with HIV, and may manifest or worsen during the menopause transition. However, research investigating the presence and acuity of these symptoms among women with HIV during menopause is limited.

Eligibility


Ages Eligible for Study:	45 Years to 52 Years (Adult)
Sexes Eligible for Study:	Female
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

Female subjects in the perimenopausal transition will be recruited via referral by infectious disease providers, newspaper advertisement, posted flyers, community based programs at local AIDS Service Organizations and Partners subject recruitment broadcast at Massachusetts General Hospital (MGH). The HIV negative control subjects will be recruited through advertisements, flyers, and email announcements. Both HIV positive and negative subjects will be recruited from the same neighborhoods to ensure similar demographic characteristics.

Criteria

Inclusion Criteria:

Females age 45 -52.
Females in the perimenopausal transition characterized by the presence of abnormal menstrual function, defined as less than 3 periods in the past 3 months, 1 cycle >60 days in length in the prior 6 months, or irregular menses in 2 or more cycles within the past 6 months. Women who have been amenorrheic for >12 months will not be eligible. 3. Women with HIV must have previously documented HIV and be receiving a stable treatment regimen for > 3 months.

Exclusion Criteria:

Use of estrogen, combination hormone replacement therapy, oral contraceptive pills/patches, Depo Provera, glucocorticoids, testosterone, growth hormone or other anabolic steroids within the past 6 months.
Diabetes and current use of insulin, or medications known to affect glucose or insulin levels.
Positive pregnancy test or recently pregnant within the past year or lactating.
Presence of active cancers.
Current use of bisphosphonates, or a diagnosis of Paget's disease or other illnesses known to affect bone (Use of calcium and Vitamin D will be permitted).
Opportunistic infection within 3 months of study participation (HIV positive subjects).

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01142817

Locations


United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114

Sponsors and Collaborators

Massachusetts General Hospital

Investigators


Principal Investigator:	Sara E Looby, PhD, ANP	Massachusetts General Hospital

More Information

Publications:

Looby SE. Menopause-associated metabolic manifestations and symptomatology in HIV infection: a brief review with research implications. J Assoc Nurses AIDS Care. 2012 May-Jun;23(3):195-203. doi: 10.1016/j.jana.2011.06.008. Epub 2011 Sep 15. Review.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Looby SE, Shifren J, Corless I, Rope A, Pedersen MC, Joffe H, Grinspoon S. Increased hot flash severity and related interference in perimenopausal human immunodeficiency virus-infected women. Menopause. 2014 Apr;21(4):403-9. doi: 10.1097/GME.0b013e31829d4c4c.


Responsible Party:	Sara E. Dolan Looby, PhD, ANP-BC, Principal Investigator, Massachusetts General Hospital
ClinicalTrials.gov Identifier:	NCT01142817 History of Changes
Other Study ID Numbers:	2009P-001315
Study First Received:	June 10, 2010
Last Updated:	August 6, 2013

Keywords provided by Sara E. Dolan Looby, PhD, ANP-BC, Massachusetts General Hospital:


HIV Women Menopause Dyslipidemia Bone Mineral Density

Additional relevant MeSH terms:


HIV Infections Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases	Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases

ClinicalTrials.gov processed this record on May 25, 2017