The impact of sex on HIV immunopathogenesis and therapeutic interventions

Globally, the majority of people living with HIV are women or girls, but they have been a minority of participants in clinical trials and observational studies of HIV. Despite this underrepresentation, differences in the pathogenesis of HIV have been observed between men and women, with contribution...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of clinical investigation 2024-09, Vol.134 (18)
Main Authors: Mihealsick, Erin, Word, Anna, Scully, Eileen P
Format: Article
Language:English
Subjects:
B cells
Development and progression
Female
Gonadal Steroid Hormones - immunology
HIV (Viruses)
HIV Infections - immunology
HIV-1 - immunology
Humans
Male
Medical research
Medicine, Experimental
Review Series
Sex Characteristics
Sex Factors
Steroid hormones
Viral Load
Virus diseases
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Globally, the majority of people living with HIV are women or girls, but they have been a minority of participants in clinical trials and observational studies of HIV. Despite this underrepresentation, differences in the pathogenesis of HIV have been observed between men and women, with contributions from both gender- and sex-based factors. These include differences in the risk of HIV acquisition, in viral load set point and immune activation in responses to viremia, and differences in HIV reservoir maintenance. These differences obligate adequate study in both males and females in order to optimize treatments, but also provide a powerful leverage point for delineating the mechanisms of HIV pathogenesis. The shifts in exposure to sex steroid hormones across a lifespan introduce additional complexity, which again can be used to focus on either genetic or hormonal influences as the driver of an outcome. In this Review, we discuss consistent and reproducible differences by sex across the spectrum of HIV, from acquisition through pathogenesis, treatment, and cure, and explore potential mechanisms and gaps in knowledge.
ISSN:1558-8238
0021-9738
1558-8238
DOI:10.1172/JCI180075