This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hel, Z. Articles by Mestecky, J. Search for Related Content PubMed PubMed Citation Articles by Hel, Z. Articles by Mestecky, J.

Sex Steroid Hormones, Hormonal Contraception, and the Immunobiology of Human Immunodeficiency Virus-1 Infection

Departments of Pathology (Z.H.) and Microbiology (Z.H., J.M.), Center for AIDS Research (Z.H., E.S., J.M.), Mucosal HIV and Immunobiology Center (Z.H., J.M.), Department of Obstetrics and Gynecology (E.S.), and Department of Medicine (J.M.), University of Alabama at Birmingham, Birmingham, Alabama 35294-2170

Correspondence: Address all correspondence and requests for reprints to: Zdenek Hel, Ph.D., Department of Pathology, University of Alabama at Birmingham, 845 19th Street South, BBRB 730, Birmingham, Alabama 35294-2170. E-mail: zhel{at}uab.edu.

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.