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Review
. 2016 Feb 18;19(1):20706.
doi: 10.7448/IAS.19.1.20706. eCollection 2016.

Barriers to a cure for HIV in women

Sara Gianella  1 , Athe Tsibris  2 , Liz Barr  3 , Catherine Godfrey  4
Affiliations
Review

Barriers to a cure for HIV in women

Sara Gianella et al. J Int AIDS Soc. .

Abstract

Introduction: 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 enrollment 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.

Keywords: HIV cure; HIV eradication; anatomic compartments; female genital tract; immune system; women's health.

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Figures

Figure 1
Figure 1
Effect of oestrogen on immune cells, as T cells, B cells, dendritic cells, Monocytes/Macrophages, neutrophils and natural killer (NK) cells.
See this image and copyright information in PMC

References

    1. Palella FJ, Jr, Baker RK, Moorman AC, Chmiel JS, Wood KC, Brooks JT, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. 2006;43(1):27–34. - PubMed
    1. Wong JK, Hezareh M, Gunthard HF, Havlir DV, Ignacio CC, Spina CA, et al. Recovery of replication-competent HIV despite prolonged suppression of plasma viremia. Science. 1997;278(5341):1291–5. - PubMed
    1. Hoen B, Fournier I, Lacabaratz C, Burgard M, Charreau I, Chaix ML, et al. Structured treatment interruptions in primary HIV-1 infection: the ANRS 100 PRIMSTOP trial. J Acquir Immune Defic Syndr. 2005;40(3):307–16. - PubMed
    1. Ho YC, Shan L, Hosmane NN, Wang J, Laskey SB, Rosenbloom DI, et al. Replication-competent noninduced proviruses in the latent reservoir increase barrier to HIV-1 cure. Cell. 2013;155(3):540–51. - PMC - PubMed
    1. Margolis DM. How might we cure HIV? Curr Infect Dis Rep. 2014;16(3):392. - PubMed

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