Case series of infertility amongst young women with perinatally acquired HIV: data from a London cohort

Introduction Increased rates of infertility have been reported in women who acquired HIV horizontally compared to population age-matched normative data. However, few data exist for adults with perinatally acquired HIV (PaHIV), who have been exposed to antiretroviral drugs and/or HIV-associated ill health through childhood and puberty. We describe a case series of infertility amongst women with PaHIV attending a London clinic between 2006 and 2017. Methods A retrospective case-note review was conducted amongst all female PaHIV patients aged >16 years attending a London clinic. All data was captured into an electronic database using paper and electronic clinical records taken from every routine clinic visit (average three times/year between 2006 and 2017). Data captured included HIV viral load, CD4 cell count, antiretroviral therapy regimen, sexual and reproductive health and STI screening. Age-matched analysis of infertility rates compared to the general population were not performed. Results In total, 119 young women were included, with a median age of 20 years (interquartile range [IQR] 18–24, range 16–33 years) at latest follow-up. Three women with PaHIV were diagnosed with infertility (n=3): two with primary ovarian insufficiency (n=2) and one with hypogonadotropic hypogonadism (n=1). A further 5/116 (4.3%) were under investigation for menstrual irregularities. Of the remaining 111 young women, 17 (15%) had successfully conceived. All patients were currently prescribed ART, with 93 (78%) having an HIV VL 25 kg/m2 (63% vs 30%). Conclusion Overall the reproductive health status for young women with PaHIV was comparable to the general population.