Women have a greater immunological response to effective HAART

A retrospective analysis of data from 53 women and 60 men, published in the 5 September issue of AIDS, compared the immunological responses of women to men in patients with suppressed viral load <400 copies/ml at 24 weeks.

Of the patients analysed, 49% were described as African American, 30% Hispanic and 21% Caucasian. Thirty percent of both men and women were antiretroviral naïve. All patients in both groups received combination therapy.

Sixty one percent received a protease inhibitor and two nucleoside analogues; 30%, an NNRTI and two nucleosides and 5% used triple nucleosides.

On initiation of therapy, CD4 counts and viral load were similar in both groups but the mean CD4 count change was much greater in women then in men, 170 cells and 100 cells respectively (p=0.0074). Multivariate analysis failed to show any contribution of either the patients’ age or initial viral load.

The investigators report: “Our data reveal that, among virological responders, women have a greater response.” They report that the reasons for this are unclear and they note: “The larger increase in CD4 T-cells seen in women suggests that significant pathological differences may exist between the two sexes.” They add: “Our findings warrant further investigation of the immunological differences between the two sexes.”

Finkel DG, John G, Holland B et al. Women have a greater immunological response to effective virological HIV-1 therapy AIDS 2003 17 (13): 2009-2011