Abstract
Sex differences have been reported for multiple aspects of human immunodeficiency virus (HIV)-1 infection, including transmission, pathogenesis, morbidity, mortality, and responses to antiretroviral treatment. Epidemiological studies on sex differences in HIV-1 infection are numerous and in some instances controversial. The intrinsic interplay between multilayered socioeconomic factors and biological factors renders drawing definitive conclusions on sex differences in HIV-1 infection challenging. Nevertheless, some findings such as the lower viremia observed in women than in men have been consistently observed in multiple studies. It is also generally acknowledged that women display a greater susceptibility to HIV-1 acquisition. The simian immunodeficiency virus (SIV) model has been critical for understanding the biological characteristics of the female genital tract responsible for this greater susceptibility. Immune activation is another key factor in HIV-1 acquisition and pathogenesis that distinguishes men and women, with women exhibiting higher levels of immune activation. Data to date have pointed toward an important role of sex hormones in mediating these sex differences observed in the manifestation of HIV-1 disease. This chapter will focus on the discussion of (1) sex differences in HIV-1 acquisition and transmission, (2) sex differences in HIV-1 pathology, and (3) the impact of sex hormones including those exogenously delivered during contraceptive use. Sex differences related to responses to antiretroviral treatment go beyond the scope of this chapter and are reviewed in Chap. 4.
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Abbreviations
- ADI:
-
AIDS-defining illness
- AIDS:
-
Acquired immunodeficiency syndrome
- ART:
-
Antiretroviral therapy
- cART:
-
Combination antiretroviral therapy
- CDC:
-
Centers for Disease Controls and Prevention
- CMV:
-
Cytomegalovirus
- CTL:
-
Cytotoxic CD8+ T lymphocytes
- DMPA:
-
Depot medroxyprogesterone acetate
- ERα:
-
Estrogen receptor alpha
- FDC:
-
Follicular dendritic cells
- FSW:
-
Female sex workers
- GM-CSF:
-
Granulocyte-macrophage colony-stimulating factor
- HESN:
-
HIV-1-exposed seronegative
- HHV-8:
-
Human herpesvirus 8
- HIV:
-
Human immunodeficiency virus
- HPV:
-
Human papillomavirus (HPV)
- HSV-2:
-
Herpes simplex virus 2
- IDO:
-
Indoleamine (2,3)-dioxygenase
- IDU:
-
Intravenous drug users
- IFI16:
-
Gamma-interferon-inducible protein 16
- IFNα:
-
Interferon-α
- IHC:
-
Injectable hormonal contraception
- IL-1β:
-
Interleukin-1β
- IL-2:
-
Interleukin 2
- IL-6:
-
Interleukin 6
- IL-12:
-
Interleukin 12
- ISGs:
-
Interferon-stimulated genes
- IUDs:
-
Intrauterine devices
- KS:
-
Kaposi’s sarcoma
- LCs:
-
Langerhans cells
- LPS:
-
Lipopolysaccharide
- MDR:
-
Multidrug resistant
- MIP-3α:
-
Macrophage inflammatory protein 3α
- MIP-1α:
-
Macrophage inflammatory protein 1α
- MIP-1β:
-
Macrophage inflammatory protein 1β
- MPA:
-
Medroxyprogesterone acetate
- MSM:
-
Men who have sex with men
- MTCT:
-
Mother-to-child transmission
- MX-1:
-
Myxovirus resistance 1
- OCs:
-
Oral contraceptives
- PrEP:
-
Pre-exposure prophylaxis
- PRR:
-
Pathogen recognition receptors
- SIV:
-
Simian immunodeficiency virus
- STDs:
-
Sexually transmitted diseases
- STIs:
-
Sexually transmitted infections
- TB:
-
Tuberculosis
- TNFα:
-
Tumor necrosis factor alpha
- TLR:
-
Toll-like receptors
- USA:
-
United States
- WHO:
-
World Health Organization
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Griesbeck, M., Altfeld, M. (2015). Sex Differences in the Manifestations of HIV-1 Infection. In: Klein, S., Roberts, C. (eds) Sex and Gender Differences in Infection and Treatments for Infectious Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-16438-0_5
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