Barriers to a cure for HIV in women

Introduction Distinct biological factors exist that affect the natural history of HIV and the host immune response between women and men. These differences must be addressed to permit the optimal design of effective HIV eradication strategies for much of the HIV‐positive population. Methods and resu...

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Bibliographic Details
Published in:Journal of the International AIDS Society 2016-01, Vol.19 (1), p.20706-n/a
Main Authors: Gianella, Sara, Tsibris, Athe, Barr, Liz, Godfrey, Catherine
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
AIDS/HIV
Analysis
anatomic compartments
Anti-HIV Agents - therapeutic use
Antiviral agents
Birth control
Care and treatment
Chromosomes
Clinical trials
Cohort analysis
Disease
Dosage and administration
Drug therapy
Female
female genital tract
Females
Gender differences
Gene expression
Genetic engineering
Genitalia, Female - immunology
Gonadal Steroid Hormones - physiology
Health aspects
HIV
HIV cure
HIV eradication
HIV infection
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - etiology
HIV Infections - immunology
Hormones
Hormones, Sex
Human immunodeficiency virus
Humans
Immune response
immune system
Immunology
Infections
Internet
Lymphocytes
Male
Measurement
Natural history
Pathogenesis
Prevention
Review
Risk factors
Sex Characteristics
Sexually transmitted diseases
STD
Systematic review
Virus Latency
Women
Women's health
Womens health
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Summary:Introduction Distinct biological factors exist that affect the natural history of HIV and the host immune response between women and men. These differences must be addressed to permit the optimal design of effective HIV eradication strategies for much of the HIV‐positive population. Methods and results Here, we review the literature on sex‐based differences in HIV pathogenesis and natural history in tissues and anatomic compartments, HIV latency and transcriptional activity, and host immunity including the role of sex hormones. We then outline the potential effects of these differences on HIV persistence, and on the safety and efficacy of HIV eradication and curative interventions. Finally, we discuss the next steps necessary to elucidate these factors to achieve a cure for HIV, taking in account the complex ethical issues and the regulatory landscape in the hopes of stimulating further research and awareness in these areas. Conclusions Targeted enrolment of women in clinical trials and careful sex‐based analysis will be crucial to gain further insights into sex‐based differences in HIV persistence and to design sex‐specific approaches to HIV eradication, if required.
ISSN:1758-2652
1758-2652
DOI:10.7448/IAS.19.1.20706