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Sex differences in HIV-1-mediated immunopathology

Ziegler, Susanne; Altfeld, Marcus

Current Opinion in HIV and AIDS: March 2016 - Volume 11 - Issue 2 - p 209–215
doi: 10.1097/COH.0000000000000237
IMMUNE ACTIVATION: Edited by Irini Sereti and Marcus Altfeld
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Purpose of review The article reviews our current knowledge regarding the role of sex and sex hormones in regulating innate immune responses to viral infections, which may account for the described sex differences in immunity to HIV-1.

Recent findings Prominent sex differences exist in various infectious and autoimmune diseases. Biological mechanisms underlying these differences include the modulation of immunological pathways by sex hormones and gene dosage effects of immunomodulatory genes encoded by the X chromosome. During HIV-1 infections, women have been shown to present with lower viral load levels in primary infection, although their progression to AIDS is faster in comparison with men when accounting for viral load levels in chronic infection. HIV-1-infected women furthermore tend to have higher levels of immune activation and interferon-stimulated gene expression in comparison with men for the same viral load, which has been associated to innate sensing of HIV-1 by Toll-like receptor 7 and the consequent interferon-α production by plasmacytoid dendritic cells.

Summary Improvement in understanding the mechanisms associated with sex differences in HIV-1-mediated immunopathology will be critical to take sex differences into consideration when designing experimental and clinical studies in HIV-1-infected populations.

aDepartment of Viral Immunology, Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany

bRagon Institute of MIT, MGH and Harvard, Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Marcus Altfeld, Department of Viral Immunology, Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Martinistraße 52, 20251 Hamburg, Germany. E-mail: marcus.altfeld@hpi.uni-hamburg.de

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