May 3, 2002
IS it true that men and women progress differently? Also if two people (one male, one female) are infected with the same virus can it be more progessive in one than the other or it depends on how viralent the strain is? (This is in the absence of any treatment for statistical purposes) I've heard something about womens estrogen keeps them healtier longer.Also are men more prone to oi's and dementia or there is no difference?
Response from Dr. Pavia
Great questions, and the answers are longer than I can post here. It is important to know that we still don't have enough studies looking at gender differences
Here is the short answer. Women and men appear to progress at the same rate to clinical disease. However, early studies suggested women progressed FASTER. It was appreciated later that this was most likely due to differences in access to care. More recently, a number of studies showed that women had slightly lower viral loads at a given CD4 count early in disease. This difference seems to go away over time, and our best understanding is that it does not influence when one should start treatment.
Two people infected with the same virus may progress at very different rates. Virulence of a viral strain matters, but so does the host. Here are some of the factors:
Genetics. Some people are very resistant to infection and progression based on their co receptor genes. Others are more susceptible
Genetics. Some HLA types seem to allow better immune responses to HIV in general and certain strains in particular.
Immune system. The way your body mounts its initial immune counterattack determines how long that immune response will last.
Age. Younger persons generally progress slower than older persons.
Self care. Studies vary, but good nutrition, good mental health, good excercise, and avoiding certain drugs of abuse help a great deal.
Hope this helps
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