Sex-based differences in human immunodeficiency virus type 1 reservoir activity and residual immune activation

Eileen P. Scully, Monica Gandhi, Rowena Johnston, Rebecca Hoh, Ainsley Lockhart, Curtis Dobrowolski, Amélie Pagliuzza, Jeffrey M. Milush, Christopher A. Baker, Valerie Girling, Arlvin Ellefson, Robert Gorelick, Jeffrey Lifson, Marcus Altfeld, Galit Alter, Marcelle Cedars, Ajantha Solomon, Sharon R. Lewin, Jonathan Karn, Nicolas ChomontPeter Bacchetti, Steven G. Deeks

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Plasma human immunodeficiency virus type 1 (HIV-1) RNA levels in women are lower early in untreated HIV-1 infection compared with those in men, but women have higher T-cell activation and faster disease progression when adjusted for viral load. It is not known whether these sex differences persist during effective antiretroviral therapy (ART), or whether they would be relevant for the evaluation and implementation of HIV-1 cure strategies. We prospectively enrolled a cohort of reproductive-aged women and matched men on suppressive ART and measured markers of HIV-1 persistence, residual virus activity, and immune activation. The frequency of CD4+ T cells harboring HIV-1 DNA was comparable between the sexes, but there was higher cell-associated HIV-1 RNA, higher plasma HIV-1 (single copy assay), and higher T-cell activation and PD-1 expression in men compared with women. These sex-related differences in immune phenotype and HIV-1 persistence on ART have significant implications for the design and measurement of curative interventions.

Original languageEnglish (US)
Pages (from-to)1084-1094
Number of pages11
JournalJournal of Infectious Diseases
Volume219
Issue number7
DOIs
StatePublished - Mar 15 2019

Keywords

  • Cure
  • HIV-1
  • Immune activation
  • Reservoir
  • Sex differences

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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