Rao Shringar
Department of Biochemistry, Erasmus University Medical Centre, Rotterdam, Netherlands.
Front Glob Womens Health. 2022 Sep 23;3:942345. doi: 10.3389/fgwh.2022.942345. eCollection 2022.
Of the 38 million people currently living with Human Immunodeficiency Virus type-1 (HIV-1), women, especially adolescents and young women, are disproportionally affected by the HIV-1 pandemic. Acquired immunodeficiency syndrome (AIDS) - related illnesses are the leading cause of death in women of reproductive age worldwide. Although combination antiretroviral therapy (cART) can suppress viral replication, cART is not curative due to the presence of a long-lived viral reservoir that persists despite treatment. Biological sex influences the characteristics of the viral reservoir as well as the immune responses to infection, factors that can have a significant impact on the design and quantification of HIV-1 curative interventions in which women are grossly underrepresented. This mini-review will provide an update on the current understanding of the impact of biological sex on the viral reservoir and will discuss the implications of these differences in the context of the development of potential HIV-1 curative strategies, with a focus on the shock and kill approach to an HIV-1 cure. This mini-review will also highlight the current gaps in the knowledge of sex-based differences in HIV-1 persistence and will speculate on approaches to address them to promote the development of more scalable, effective curative approaches for people living with HIV-1.
在目前感染1型人类免疫缺陷病毒（HIV-1）的3800万人中，女性，尤其是青少年和年轻女性，受HIV-1大流行的影响尤为严重。获得性免疫缺陷综合征（AIDS）相关疾病是全球育龄妇女的主要死因。尽管联合抗逆转录病毒疗法（cART）可以抑制病毒复制，但由于存在长期存在的病毒库，即使经过治疗仍会持续存在，所以cART并不能治愈疾病。生理性别会影响病毒库的特征以及对感染的免疫反应，这些因素会对HIV-1治愈性干预措施的设计和量化产生重大影响，而在这些干预措施中女性的代表性严重不足。本综述将更新目前对生理性别对病毒库影响的理解，并将在潜在的HIV-1治愈策略发展的背景下讨论这些差异的影响，重点是针对HIV-1治愈的“激活并清除”方法。本综述还将强调目前在HIV-1持续存在的性别差异知识方面的差距，并推测解决这些差距的方法，以促进为HIV-1感染者开发更具可扩展性、更有效的治愈方法。
