Department of Pathology, University of Alabama at Birmingham, 845 19th Street South, Birmingham, Alabama 35294-2170, USA.
Endocr Rev. 2010 Feb;31(1):79-97. doi: 10.1210/er.2009-0018. Epub 2009 Nov 10.
Worldwide, an increasing number of women use oral or injectable hormonal contraceptives. However, inadequate information is available to aid women and health care professionals in weighing the potential risks of hormonal contraceptive use in individuals living with HIV-1 or at high risk of infection. Numerous epidemiological studies and challenge studies in a rhesus macaque model suggest that progesterone-based contraceptives increase the risk of HIV-1 infection in humans and simian immunodeficiency virus (SIV) infection in macaques, accelerate disease progression, and increase viral shedding in the genital tract. However, because several other studies in humans have not observed any effect of exogenously administered progesterone on HIV-1 acquisition and disease progression, the issue continues to be a topic of intense research and ongoing discussion. In contrast to progesterone, systemic or intravaginal treatment with estrogen efficiently protects female rhesus macaques against the transmission of SIV, likely by enhancing the natural protective properties of the lower genital tract mucosal tissue. Although the molecular and cellular mechanisms underlying the effect of sex steroid hormones on HIV-1 and SIV acquisition and disease progression are not well understood, progesterone and estrogen are known to regulate a number of immune mechanisms that may exert an effect on retroviral infection. This review summarizes current knowledge of the effects of various types of sex steroid hormones on immune processes involved in the biology of HIV-1 infection.
在全球范围内，越来越多的女性使用口服或注射用激素避孕药。然而，对于帮助女性和医疗保健专业人员权衡激素避孕药在 HIV-1 感染者或感染高风险人群中使用的潜在风险，现有的信息还不够充分。许多流行病学研究和恒河猴模型中的挑战研究表明，孕激素类避孕药会增加人类感染 HIV-1 和猕猴感染猴免疫缺陷病毒（SIV）的风险，加速疾病进展，并增加生殖道的病毒脱落。然而，由于其他几项在人类中进行的研究并未观察到外源性孕激素对 HIV-1 感染和疾病进展的任何影响，因此这个问题仍然是一个研究热点，也是持续讨论的话题。与孕激素相反，系统或阴道内给予雌激素能有效地保护雌性恒河猴免受 SIV 的传播，这可能是通过增强下生殖道黏膜组织的天然保护特性。尽管性甾体激素对 HIV-1 和 SIV 感染和疾病进展的影响的分子和细胞机制尚不清楚，但已知孕激素和雌激素可调节许多免疫机制，这些机制可能对逆转录病毒感染产生影响。这篇综述总结了目前关于各种类型的性甾体激素对涉及 HIV-1 感染生物学的免疫过程的影响的认识。
