Sex influences immune responses to viruses, and efficacy of prophylaxis and treatments for viral diseases

Abstract

Summary The intensity and prevalence of viral infections are typically higher in males, whereas disease outcome can be worse for females. Females mount higher innate and adaptive immune responses than males, which can result in faster clearance of viruses, but also contributes to increased development of immunopathology. In response to viral vaccines, females mount higher antibody responses and experience more adverse reactions than males. The efficacy of antiviral drugs at reducing viral load differs between the sexes, and the adverse reactions to antiviral drugs are typically greater in females than males. Several variables should be considered when evaluating male/female differences in responses to viral infection and treatment: these include hormones, genes, and gender-specific factors related to access to, and compliance with, treatment. Knowledge that the sexes differ in their responses to viruses and to treatments for viral diseases should influence the recommended course of action differently for males and females.

Vaccine Induction of Lymph Node–Resident Simian Immunodeficiency Virus Env-Specific T Follicular Helper Cells in Rhesus Macaques

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Sex differences in HIV-1-mediated immunopathology

“…In general, women have been reported to display an overall reduced susceptibility to viral infections, potentially due to stronger innate, cellular and humoral immune responses compared to men(1, 8–11). This enhanced level of immune responses and activation, however, can have detrimental consequences for disease outcomes resulting from immune pathology, in particular for chronic persistent infections.…”