Sex Differences in HIV Infection

Purpose of Review This review will outline the multilevel effects of biological sex on HIV acquisition, pathogenesis, treatment response, and prospects for cure. Potential mechanisms will be discussed along with future research directions. Recent Findings HIV acquisition risk is modified by sex horm...

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Bibliographic Details
Published in:Current HIV/AIDS reports 2018-04, Vol.15 (2), p.136-146
Main Author: Scully, Eileen P.
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Antiretroviral drugs
Disease prevention
Drug metabolism
Gender differences
HIV
HIV Pathogenesis and Treatment (AL Landay and N Utay
HIV Pathogenesis and Treatment (AL Landay and N Utay, Section Editors)
Human immunodeficiency virus
Latency
Medicine
Medicine & Public Health
Microbiomes
Pathogenesis
Prophylaxis
Section Editors
Sex differences
Sex hormones
Topical Collection on HIV Pathogenesis and Treatment
Vagina
Women
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Summary:Purpose of Review This review will outline the multilevel effects of biological sex on HIV acquisition, pathogenesis, treatment response, and prospects for cure. Potential mechanisms will be discussed along with future research directions. Recent Findings HIV acquisition risk is modified by sex hormones and the vaginal microbiome, with the latter acting through both inflammation and local metabolism of pre-exposure prophylaxis drugs. Female sex associates with enhanced risk for non-AIDS morbidities including cardiovascular and cerebrovascular disease, suggesting different inflammatory profiles in men and women. Data from research on HIV cure points to sex differences in viral reservoir dynamics and a direct role for sex hormones in latency maintenance. Summary Biological sex remains an important variable in determining the risk of HIV infection and subsequent viral pathogenesis, and emerging data suggest sex differences relevant to curative interventions. Recruitment of women in HIV clinical research is a pathway to both optimize care for women and to identify novel therapeutics for use in both men and women.
ISSN:1548-3568
1548-3576
DOI:10.1007/s11904-018-0383-2