Abstract
IntroductionDistinct 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 resultsHere, 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.ConclusionsTargeted 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.
Highlights
Distinct biological factors exist that affect the natural history of HIV and the host immune response between women and men
Replication-competent HIV DNA that remains integrated in long-lived cells despite effective ART, referred to as the HIV reservoir, represents the major barrier to an HIV cure [4]
We review the literature on the fundamental differences between men and women in the immunologic response to HIV infection and pathogenesis, and we discuss the steps necessary to elucidate these factors in order to achieve HIV eradication
Summary
Antiretroviral therapy (ART) suppresses virus replication in HIV-positive individuals and reduces morbidity and mortality [1]. Replication-competent HIV DNA that remains integrated in long-lived cells despite effective ART, referred to as the HIV reservoir, represents the major barrier to an HIV cure [4]. Differences in sex, age, and race may influence the HIV reservoir and the host immune response to these therapeutic approaches as a consequence of hormone fluctuations, anatomic characteristics, genetic differences, drug responses, and other factors [6,7]. Such factors could affect the safety and efficacy of curative interventions. We review the literature on the fundamental differences between men and women in the immunologic response to HIV infection and pathogenesis, and we discuss the steps necessary to elucidate these factors in order to achieve HIV eradication
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
