Sex and gender differences in HIV-1 infection

Morgane Griesbeck, Eileen Scully, Marcus Altfeld

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1435-1451
Number of pages17
JournalClinical Science
Issue number16
StatePublished - 2016
Externally publishedYes


  • Acquisition
  • HIV-1
  • Immune activation
  • Oestrogen signalling
  • Sex
  • Viral loads

ASJC Scopus subject areas

  • Medicine(all)


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