Open AccessBarriers to a cure for HIV in women
Author(s) -
Gianella Sara,
Tsibris Athe,
Barr Liz,
Godfrey Catherine
Publication year - 2016
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.19.1.20706
Subject(s) - medicine , natural history , human immunodeficiency virus (hiv) , clinical trial , psychological intervention , hiv vaccine , population , persistence (discontinuity) , immunology , environmental health , psychiatry , vaccine trial , geotechnical engineering , engineering
Distinct 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 results Here, 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. Conclusions Targeted 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.