title: Sex and gender differences in HIV-1 infection.
abstract: The major burden of the human immunodeficiency (HIV) type 1 pandemic is nowadays carried by women from sub-Saharan Africa. Differences in the manifestations of HIV-1 infection between women and men have been long reported, and might be due to both socio-economic (gender) and biological (sex) factors. Several studies have shown that women are more susceptible to HIV-1 acquisition than men. Following HIV-1 infection, women have lower viral loads during acute infection and exhibit stronger antiviral responses than men, which may contribute to differences in the size of viral reservoirs. Oestrogen receptor signalling could represent an important mediator of sex differences in HIV-1 reservoir size and may represent a potential therapeutic target. Furthermore, immune activation, a hallmark of HIV-1 infection, is generally higher in women than in men and could be a central mechanism in the sex difference observed in the speed of HIV-1 disease progression. Here, we review the literature regarding sex-based differences in HIV-1 infection and discuss how a better understanding of the underlying mechanisms could improve preventive and therapeutic strategies.
authors.affiliation: Center for immunology and infectious diseases (CIMI), Paris 75013, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Griesbeck
authors.affiliation: Ragon Institute of MGH, MIT and Harvard, Cambridge 02139, U.S.A.
authors.forename: Eileen
authors.initials: E
authors.lastname: Scully
authors.affiliation: Heinrich-Pette-Institute, Hamburg 20251, Germany marcus.altfeld@hpi.uni-hamburg.de.
authors.forename: Marcus
authors.initials: M
authors.lastname: Altfeld
mesh_terms: D004198:Disease Susceptibility; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000276:immunology / Q000473:pathology* / Q000821:virology; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D008297:Male; D012737:Sex Factors
keywords: HIV-1; acquisition; immune activation; oestrogen signalling; sex; viral loads