Skip to main content

Sex Differences in Prophylaxis and Therapeutic Treatments for Viral Diseases

  • Chapter
  • First Online:
Book cover Sex and Gender Differences in Pharmacology

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 214))

Abstract

The intensity and prevalence of viral infections are typically higher in males than in females. In contrast, disease outcome can be worse for females. Males and females also differ in their responses to prophylaxis and therapeutic treatments for viral diseases. In response to vaccines against herpes viruses, hepatitis viruses, influenza viruses, and others, females consistently mount higher humoral immune responses and experience more frequent and severe adverse reactions than males. Males and females also differ in the absorption, metabolism, and clearance of antiviral drugs. The pharmacological effects, including toxicity and adverse reactions, of antiviral drugs are typically greater in females than males. The efficacy of antiviral drugs at reducing viral load also differs between the sexes, with antiviral treatments being better at clearing HIV and hepatitis C virus in females, but showing greater reduction of herpes simplex virus and influenza A virus loads in males. Biological variables, including hormone and genes, as well as gender-specific factors related to access and compliance to drug regimens must be considered when evaluating male–female differences in responses to treatments for viral diseases. Clinicians, epidemiologists, and basic biomedical scientists should design experiments that include both males and females, develop a priori hypotheses that the sexes will differ in their responses to and the outcome of vaccines and antiviral treatments, and statistically analyze outcome data by sex. Knowledge that the sexes differ in response to prophylaxis and therapeutic treatments for viral diseases should influence the recommended course of treatment differently for males and females.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

E2:

Estradiol

HIV:

Human immunodeficiency virus

HSV:

Herpes simplex virus

HBV/HCV:

Hepatitis B or C virus

P4:

Progesterone

T:

Testosterone

References

  • Amadori A, Zamarchi R, de Silvestro G, Forza G, Cavatton G, Danieli GA, Clementi M, Chieco-Bianchi L (1995) Genetic control of the CD4/CD8 T-cell ratio in humans. Nat Med 1:1279–83

    Article  PubMed  CAS  Google Scholar 

  • Andany N, Raboud JM, Walmsley S, Diong C, Rourke SB, Rueda S, Rachlis A, Wobeser W, Macarthur RD, Binder L, Rosenes R, Loutfy MR (2011) Ethnicity and gender differences in lipodystrophy of HIV-positive individuals taking antiretroviral therapy in Ontario, Canada. HIV Clin Trials 12:89–103

    Article  PubMed  Google Scholar 

  • Anderson PL, Kakuda TN, Kawle S, Fletcher CV (2003) Antiviral dynamics and sex differences of zidovudine and lamivudine triphosphate concentrations in HIV-infected individuals. AIDS 17:2159–68

    Article  PubMed  CAS  Google Scholar 

  • Anker M (2007) Addressing sex and gender in epidemic-prone infectious diseases. World Health Organization Press, Geneva, pp 1–40

    Google Scholar 

  • Araneo BA, Dowell T, Diegel M, Daynes RA (1991) Dihydrotestosterone exerts a depressive influence on the production of interleukin-4 (IL-4), IL-5, and gamma-interferon, but not IL-2 by activated murine T cells. Blood 78:688–99

    PubMed  CAS  Google Scholar 

  • Armien B, Pascale JM, Bayard V, Munoz C, Mosca I, Guerrero G, Armien A, Quiroz E, Castillo Z, Zaldivar Y, Gracia F, Hjelle B, Koster F (2004) High seroprevalence of hantavirus infection on the Azuero peninsula of Panama. Am J Trop Med Hyg 70:682–7

    PubMed  Google Scholar 

  • Arnold AP, Chen X (2009) What does the “four core genotypes” mouse model tell us about sex differences in the brain and other tissues? Front Neuroendocrinol 30:1–9

    Article  PubMed  Google Scholar 

  • Balogun MA, Vyse AJ, Hesketh LM, Kafatos G, Parry JV, Ramsay ME (2009) Estimating hepatitis C infection acquired in England, 1986–2000. Epidemiol Infect 137:1249–54

    Article  PubMed  CAS  Google Scholar 

  • Barrat F, Lesourd B, Boulouis HJ, Thibault D, Vincent-Naulleau S, Gjata B, Louise A, Neway T, Pilet C (1997) Sex and parity modulate cytokine production during murine ageing. Clin Exp Immunol 109:562–8

    Article  PubMed  CAS  Google Scholar 

  • Berghofer B, Frommer T, Haley G, Fink L, Bein G, Hackstein H (2006) TLR7 ligands induce higher IFN-alpha production in females. J Immunol 177:2088–96

    PubMed  Google Scholar 

  • Bersoff-Matcha SJ, Miller WC, Aberg JA, Van Der Horst C, Hamrick HJ Jr, Powderly WG, Mundy LM (2001) Sex differences in nevirapine rash. Clin Infect Dis 32:124–9

    Article  PubMed  CAS  Google Scholar 

  • Beyer WE, Palache AM, Kerstens R, Masurel N (1996) Gender differences in local and systemic reactions to inactivated influenza vaccine, established by a meta-analysis of fourteen independent studies. Eur J Clin Microbiol Infect Dis 15:65–70

    Article  PubMed  CAS  Google Scholar 

  • Bhattacharya D, Umbleja T, Carrat F, Chung RT, Peters MG, Torriani F, Andersen J, Currier JS (2010) Women experience higher rates of adverse events during hepatitis C virus therapy in HIV infection: a meta-analysis. J Acquir Immune Defic Syndr 55:170–5

    Article  PubMed  Google Scholar 

  • Blanchon T, Mentre F, Charlois-ou C, Dornic Q, Mosnier A, Bouscambert M, Carrat F, Duval X, Enouf V, Leport C (2011) Factors associated with clinical and virological response in patients treated with oseltamivir or zanamivir for influenza A during the 2008–2009 winter. Clin Microbiol Infect

    Google Scholar 

  • Bock HL, Kruppenbacher J, Sanger R, Hobel W, Clemens R, Jilg W (1996) Immunogenicity of a recombinant hepatitis B vaccine in adults. Arch Intern Med 156:2226–31

    Article  PubMed  CAS  Google Scholar 

  • Boissier J, Chlichlia K, Digon Y, Ruppel A, Mone H (2003) Preliminary study on sex-related inflammatory reactions in mice infected with Schistosoma mansoni. Parasitol Res 91:144–50

    Article  PubMed  CAS  Google Scholar 

  • Breidbart S, Burk RD, Saenger P (1993) Hormonal regulation of hepatitis B virus gene expression: influence of androgen receptor. Pediatr Res 34:300–2

    Article  PubMed  CAS  Google Scholar 

  • Burch J, Corbett M, Stock C, Nicholson K, Elliot AJ, Duffy S, Westwood M, Palmer S, Stewart L (2009) Prescription of anti-influenza drugs for healthy adults: a systematic review and meta-analysis. Lancet Infect Dis 9:537–45

    Article  PubMed  CAS  Google Scholar 

  • Burgos JS, Ramirez C, Sastre I, Alfaro JM, Valdivieso F (2005) Herpes simplex virus type 1 infection via the bloodstream with apolipoprotein E dependence in the gonads is influenced by gender. J Virol 79:1605–12

    Article  PubMed  CAS  Google Scholar 

  • Burguete-Garcia AI, Conde-Gonzalez CJ, Jimenez-Mendez R, Juarez-Diaz Y, Meda-Monzon E, Torres-Poveda K, Madrid-Marina V (2011) Hepatitis C seroprevalence and correlation between viral load and viral genotype among primary care clients in Mexico. Salud Publica Mex 53(Suppl 1):S7–12

    PubMed  Google Scholar 

  • Butterworth M, McClellan B, Allansmith M (1967) Influence of sex in immunoglobulin levels. Nature 214:1224–5

    Article  PubMed  CAS  Google Scholar 

  • Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, Huang GT, Iloeje UH (2006) Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA 295:65–73

    Article  PubMed  CAS  Google Scholar 

  • Chen JM, Chen JW, Dai JJ, Sun YX (2007) A survey of human cases of H5N1 avian influenza reported by the WHO before June 2006 for infection control. Am J Infect Control 35:467–9

    Article  PubMed  Google Scholar 

  • Chen KF, Gaydos C, Rothman RE (2009) Update on emerging infections: news from the Centers for Disease Control and Prevention. Hospitalized patients with novel influenza A (H1N1) virus infection – California, April–May, 2009. Ann Emerg Med 54:732–6

    Article  PubMed  Google Scholar 

  • Cherpes TL, Melan MA, Kant JA, Cosentino LA, Meyn LA, Hillier SL (2005) Genital tract shedding of herpes simplex virus type 2 in women: effects of hormonal contraception, bacterial vaginosis, and vaginal group B Streptococcus colonization. Clin Infect Dis 40:1422–8

    Article  PubMed  Google Scholar 

  • Chor JS, Ngai KL, Goggins WB, Wong MC, Wong SY, Lee N, Leung TF, Rainer TH, Griffiths S, Chan PK (2009) Willingness of Hong Kong healthcare workers to accept pre-pandemic influenza vaccination at different WHO alert levels: two questionnaire surveys. Br Med J 339:b3391

    Article  Google Scholar 

  • Christeff N, Lortholary O, Casassus P, Thobie N, Veyssier P, Torri O, Guillevin L, Nunez EA (1996) Relationship between sex steroid hormone levels and CD4 lymphocytes in HIV infected men. Exp Clin Endocrinol Diabetes 104:130–6

    Article  PubMed  CAS  Google Scholar 

  • Cook DN, Beck MA, Coffman TM, Kirby SL, Sheridan JF, Pragnell IB, Smithies O (1995) Requirement of MIP-1 alpha for an inflammatory response to viral infection. Science 269:1583–5

    Article  PubMed  CAS  Google Scholar 

  • Cook IF (2008) Sexual dimorphism of humoral immunity with human vaccines. Vaccine 26:3551–5

    Article  PubMed  CAS  Google Scholar 

  • Cook IF, Barr I, Hartel G, Pond D, Hampson AW (2006) Reactogenicity and immunogenicity of an inactivated influenza vaccine administered by intramuscular or subcutaneous injection in elderly adults. Vaccine 24:2395–402

    Article  PubMed  CAS  Google Scholar 

  • Currier JS, Spino C, Grimes J, Wofsy CB, Katzenstein DA, Hughes MD, Hammer SM, Cotton DJ (2000) Differences between women and men in adverse events and CD4+ responses to nucleoside analogue therapy for HIV infection. The Aids Clinical Trials Group 175 Team. J Acquir Immune Defic Syndr 24:316–24

    Article  PubMed  CAS  Google Scholar 

  • Cussigh A, Falleti E, Fabris C, Bitetto D, Cmet S, Fontanini E, Bignulin S, Fornasiere E, Fumolo E, Minisini R, Pirisi M, Toniutto P (2011) Interleukin 6 promoter polymorphisms influence the outcome of chronic hepatitis C. Immunogenetics 63:33–41

    Article  PubMed  CAS  Google Scholar 

  • Das BR, Bhanushali AA, Khadapkar R, Jeswani KD, Bhavsar M, Dasgupta A (2008) Reference ranges for lymphocyte subsets in adults from western India: influence of sex, age and method of enumeration. Indian J Med Sci 62:397–406

    Article  PubMed  Google Scholar 

  • de Clercq E (2006) Antiviral agents active against influenza A viruses. Nat Rev Drug Discov 5:1015–25

    Article  PubMed  CAS  Google Scholar 

  • de Jong MD, Simmons CP, Thanh TT, Hien VM, Smith GJ, Chau TN, Hoang DM, Chau NV, Khanh TH, Dong VC, Qui PT, Cam BV, Ha do Q, Guan Y, Peiris JS, Chinh NT, Hien TT, Farrar J (2006) Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia. Nat Med 12:1203–7

    Article  PubMed  CAS  Google Scholar 

  • Deloia JA, Burk RD, Gearhart JD (1989) Developmental regulation of hepatitis B surface antigen expression in two lines of hepatitis B virus transgenic mice. J Virol 63:4069–73

    PubMed  CAS  Google Scholar 

  • di Martino V, Lebray P, Myers RP, Pannier E, Paradis V, Charlotte F, Moussalli J, Thabut D, Buffet C, Poynard T (2004) Progression of liver fibrosis in women infected with hepatitis C: long-term benefit of estrogen exposure. Hepatology 40:1426–33

    Article  PubMed  CAS  Google Scholar 

  • Edwards KM, Burns VE, Allen LM, McPhee JS, Bosch JA, Carroll D, Drayson M, Ring C (2007) Eccentric exercise as an adjuvant to influenza vaccination in humans. Brain Behav Immun 21:209–17

    Article  PubMed  Google Scholar 

  • El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132:2557–76

    Article  PubMed  CAS  Google Scholar 

  • Emery J, Pick N, Mills EJ, Cooper CL (2010) Gender differences in clinical, immunological, and virological outcomes in highly active antiretroviral-treated HIV-HCV coinfected patients. Patient Prefer Adherence 4:97–103

    PubMed  Google Scholar 

  • Endrich MM, Blank PR, Szucs TD (2009) Influenza vaccination uptake and socioeconomic determinants in 11 European countries. Vaccine 27:4018–24

    Article  PubMed  Google Scholar 

  • Engler RJ, Nelson MR, Klote MM, Vanraden MJ, Huang CY, Cox NJ, Klimov A, Keitel WA, Nichol KL, Carr WW, Treanor JJ (2008) Half- vs full-dose trivalent inactivated influenza vaccine (2004–2005): age, dose, and sex effects on immune responses. Arch Intern Med 168:2405–14

    Article  PubMed  Google Scholar 

  • Eshima N, Iwata O, Iwata S, Tabata M, Higuchi Y, Matsuishi T, Karukaya S (2009) Age and gender specific prevalence of HTLV-1. J Clin Virol 45:135–8

    Article  PubMed  Google Scholar 

  • Fang JW, Lai CL, Chung HT, Wu PC, Lau JY (1994) Female children respond to recombinant hepatitis B vaccine with a higher titre than male. J Trop Pediatr 40:104–7

    PubMed  CAS  Google Scholar 

  • Farza H, Salmon AM, Hadchouel M, Moreau JL, Babinet C, Tiollais P, Pourcel C (1987) Hepatitis B surface antigen gene expression is regulated by sex steroids and glucocorticoids in transgenic mice. Proc Natl Acad Sci USA 84:1187–91

    Article  PubMed  CAS  Google Scholar 

  • Farzadegan H, Hoover DR, Astemborski J, Lyles CM, Margolick JB, Markham RB, Quinn TC, Vlahov D (1998) Sex differences in HIV-1 viral load and progression to AIDS. Lancet 352:1510–4

    Article  PubMed  CAS  Google Scholar 

  • Fasina F, Ifende V, Ajibade A (2010) Avian influenza A(H5N1) in humans: lessons from Egypt. Euro Surveill 15:19473

    PubMed  CAS  Google Scholar 

  • Ferrer JF, Jonsson CB, Esteban E, Galligan D, Basombrio MA, Peralta-Ramos M, Bharadwaj M, Torrez-Martinez N, Callahan J, Segovia A, Hjelle B (1998) High prevalence of hantavirus infection in Indian communities of the Paraguayan and Argentinean Gran Chaco. Am J Trop Med Hyg 59:438–44

    PubMed  CAS  Google Scholar 

  • Fielding J, Higgins N, Gregory J, Grant K, Catton M, Bergeri I, Lester R, Kelly H (2009) Pandemic H1N1 influenza surveillance in Victoria, Australia, April–September, 2009. Euro Surveill 14:19368

    PubMed  Google Scholar 

  • Fleming DT, McQuillan GM, Johnson RE, Nahmias AJ, Aral SO, Lee FK, ST LOUIS ME (1997) Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med 337:1105–11

    Article  PubMed  CAS  Google Scholar 

  • Franklin RD, Kutteh WH (1999) Characterization of immunoglobulins and cytokines in human cervical mucus: influence of exogenous and endogenous hormones. J Reprod Immunol 42:93–106

    Article  PubMed  CAS  Google Scholar 

  • Frisancho-Kiss S, Davis SE, Nyland JF, Frisancho JA, Cihakova D, Barrett MA, Rose NR, Fairweather D (2007) Cutting edge: cross-regulation by TLR4 and T cell Ig mucin-3 determines sex differences in inflammatory heart disease. J Immunol 178:6710–4

    PubMed  CAS  Google Scholar 

  • Gallichan WS, Rosenthal KL (1996) Effects of the estrous cycle on local humoral immune responses and protection of intranasally immunized female mice against herpes simplex virus type 2 infection in the genital tract. Virology 224:487–97

    Article  PubMed  CAS  Google Scholar 

  • Gandhi M, Bacchetti P, Miotti P, Quinn TC, Veronese F, Greenblatt RM (2002) Does patient sex affect human immunodeficiency virus levels? Clin Infect Dis 35:313–22

    Article  PubMed  Google Scholar 

  • Garenne M (1994) Sex differences in measles mortality: a world review. Int J Epidemiol 23:632–42

    Article  PubMed  CAS  Google Scholar 

  • Gebo KA, Fleishman JA, Conviser R, Reilly ED, Korthuis PT, Moore RD, Hellinger J, Keiser P, Rubin HR, Crane L, Hellinger FJ, Mathews WC (2005) Racial and gender disparities in receipt of highly active antiretroviral therapy persist in a multistate sample of HIV patients in 2001. J Acquir Immune Defic Syndr 38:96–103

    Article  PubMed  Google Scholar 

  • Gillgrass A, Chege D, Bhavanam S, Kaushic C (2010) Estradiol limits viral replication following intravaginal immunization leading to diminished mucosal IgG response and non-sterile protection against genital herpes challenge. Am J Reprod Immunol 63:299–309

    Article  PubMed  CAS  Google Scholar 

  • Gillgrass AE, Ashkar AA, Rosenthal KL, Kaushic C (2003) Prolonged exposure to progesterone prevents induction of protective mucosal responses following intravaginal immunization with attenuated herpes simplex virus type 2. J Virol 77:9845–51

    Article  PubMed  CAS  Google Scholar 

  • Gillgrass AE, Fernandez SA, Rosenthal KL, Kaushic C (2005a) Estradiol regulates susceptibility following primary exposure to genital herpes simplex virus type 2, while progesterone induces inflammation. J Virol 79:3107–16

    Article  PubMed  CAS  Google Scholar 

  • Gillgrass AE, Tang VA, Towarnicki KM, Rosenthal KL, Kaushic C (2005b) Protection against genital herpes infection in mice immunized under different hormonal conditions correlates with induction of vagina-associated lymphoid tissue. J Virol 79:3117–26

    Article  PubMed  CAS  Google Scholar 

  • Gordeeva LA, Shabaldin AV, Semenova EM, Glushkov AN (2006) [Influence of genetic and phenotypical factors on the efficiency of the vaccination of young children against diphtheria and measles]. Zh Mikrobiol Epidemiol Immunobiol (2) 42–6.

    Google Scholar 

  • Grebely J, Raffa JD, Lai C, Krajden M, Conway B, Tyndall MW (2007) Factors associated with spontaneous clearance of hepatitis C virus among illicit drug users. Can J Gastroenterol 21:447–51

    PubMed  Google Scholar 

  • Grinspoon S (2005) Androgen deficiency and HIV infection. Clin Infect Dis 41:1804–5

    Article  PubMed  CAS  Google Scholar 

  • Guan Y, Poon LL, Cheung CY, Ellis TM, Lim W, Lipatov AS, Chan KH, Sturm-Ramirez KM, Cheung CL, Leung YH, Yuen KY, Webster RG, Peiris JS (2004) H5N1 influenza: a protean pandemic threat. Proc Natl Acad Sci USA 101:8156–61

    Article  PubMed  CAS  Google Scholar 

  • Guha-Sapir D, Schimmer B (2005) Dengue fever: new paradigms for a changing epidemiology. Emerg Themes Epidemiol 2:1

    Article  PubMed  Google Scholar 

  • Han X, Lundberg P, Tanamachi B, Openshaw H, Longmate J, Cantin E (2001) Gender influences herpes simplex virus type 1 infection in normal and gamma interferon-mutant mice. J Virol 75:3048–52

    Article  PubMed  CAS  Google Scholar 

  • Hannah MF, Bajic VB, Klein SL (2008) Sex differences in the recognition of and innate antiviral responses to Seoul virus in Norway rats. Brain Behav Immun 22:503–16

    Article  PubMed  CAS  Google Scholar 

  • Hawkins C, Chalamilla G, Okuma J, Spiegelman D, Hertzmark E, Aris E, Ewald T, Mugusi F, Mtasiwa D, Fawzi W (2011) Sex differences in antiretroviral treatment outcomes among HIV-infected adults in an urban Tanzanian setting. AIDS 25:1189–97

    Article  PubMed  CAS  Google Scholar 

  • Hel Z, Stringer E, Mestecky J (2010) Sex steroid hormones, hormonal contraception, and the immunobiology of human immunodeficiency virus-1 infection. Endocr Rev 31:79–97

    Article  PubMed  CAS  Google Scholar 

  • Hess G, Hingst V, Cseke J, Bock HL, Clemens R (1992) Influence of vaccination schedules and host factors on antibody response following hepatitis B vaccination. Eur J Clin Microbiol Infect Dis 11:334–40

    Article  PubMed  CAS  Google Scholar 

  • Hewagama A, Patel D, Yarlagadda S, Strickland FM, Richardson BC (2009) Stronger inflammatory/cytotoxic T-cell response in women identified by microarray analysis. Genes Immun 10:509–516

    Article  PubMed  CAS  Google Scholar 

  • Hjertqvist M, Klein SL, Ahlm C, Klingstrom J (2010) Mortality rate patterns for hemorrhagic Fever with renal syndrome caused by puumala virus. Emerg Infect Dis 16:1584–6

    Article  PubMed  Google Scholar 

  • Iversen J, Wand H, Gonnermann A, Maher L (2010) Gender differences in hepatitis C antibody prevalence and risk behaviours amongst people who inject drugs in Australia 1998–2008. Int J Drug Policy 21:471–6

    Article  PubMed  Google Scholar 

  • Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, Lindstrom S, Louie JK, Christ CM, Bohm SR, Fonseca VP, Ritger KA, Kuhles DJ, Eggers P, Bruce H, Davidson HA, Lutterloh E, Harris ML, Burke C, Cocoros N, Finelli L, Macfarlane KF, Shu B, Olsen SJ (2009) H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 374:451–8

    Article  PubMed  Google Scholar 

  • Jean CM, Honarmand S, Louie JK, Glaser CA (2007) Risk factors for West Nile virus neuroinvasive disease, California, 2005. Emerg Infect Dis 13:1918–20

    Article  PubMed  Google Scholar 

  • Jilg W, Lorbeer B, Schmidt M, Wilske B, Zoulek G, Deinhardt F (1984) Clinical evaluation of a recombinant hepatitis B vaccine. Lancet 2:1174–5

    Article  PubMed  CAS  Google Scholar 

  • Jimenez-Garcia R, Hernandez-Barrera V, Carrasco-Garrido P, Lopez de Andres A, Perez N, De Miguel AG (2008) Influenza vaccination coverages among children, adults, health care workers and immigrants in Spain: related factors and trends, 2003–2006. J Infect 57:472–80

    Article  PubMed  Google Scholar 

  • Kandun IN, Tresnaningsih E, Purba WH, Lee V, Samaan G, Harun S, Soni E, Septiawati C, Setiawati T, Sariwati E, Wandra T (2008) Factors associated with case fatality of human H5N1 virus infections in Indonesia: a case series. Lancet 372:744–9

    Article  PubMed  Google Scholar 

  • Kash JC, Tumpey TM, Proll SC, Carter V, Perwitasari O, Thomas MJ, Basler CF, Palese P, Taubenberger JK, Garcia-Sastre A, Swayne DE, Katze MG (2006) Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus. Nature 443:578–81

    PubMed  CAS  Google Scholar 

  • Katagiri D, Hayashi H, Victoriano AF, Okamoto T, Onozaki K (2006) Estrogen stimulates transcription of human immunodeficiency virus type 1 (HIV-1). Int Immunopharmacol 6:170–81

    Article  PubMed  CAS  Google Scholar 

  • Klein SL, Hodgson A, Robinson DP (2011a) Mechanisms of sex disparities in influenza pathogenesis. J Leukoc Biol 92:67–73

    Google Scholar 

  • Klein SL, Huber S (2009) Sex differences in susceptibility to viral infection. In: Klein SL, Roberts CW (eds) Sex hormones and immunity to infection. Springer, Berlin

    Google Scholar 

  • Klein SL, Jedlicka A, Pekosz A (2010) The Xs and Y of immune responses to viral vaccines. Lancet Infect Dis 10:338–49

    Article  PubMed  CAS  Google Scholar 

  • Klein SL, Marks MA, Li W, Glass GE, Fang LQ, Ma JQ, Cao WC (2011b) Sex differences in the incidence and case fatality rates from hemorrhagic Fever with renal syndrome in china, 2004–2008. Clin Infect Dis 52:1414–21

    Article  PubMed  Google Scholar 

  • Klein SL, Roberts CW (eds) (2010) Sex hormones and immunity to infection. Springer Verlag, Berlin

    Google Scholar 

  • Kobasa D, Jones SM, Shinya K, Kash JC, Copps J, Ebihara H, Hatta Y, Kim JH, Halfmann P, Hatta M, Feldmann F, Alimonti JB, Fernando L, Li Y, Katze MG, Feldmann H, Kawaoka Y (2007) Aberrant innate immune response in lethal infection of macaques with the 1918 influenza virus. Nature 445:319–23

    Article  PubMed  CAS  Google Scholar 

  • Koulentaki M, Spanoudakis S, Kantidaki E, Drandakis P, Tzagarakis N, Biziagos E, Moschandrea J, Kouroumalis EA (1999) Prevalence of hepatitis B and C markers in volunteer blood donors in Crete. A 5-year study. J Viral Hepat 6:243–8

    Article  PubMed  CAS  Google Scholar 

  • Kovats S, Carreras E, Agrawal H (2010) Sex steroid receptors in immune cells. In: Klein SL, Roberts CW (eds) Sex hormones and immunity to infection. Springer, Berlin

    Google Scholar 

  • Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA (2009) Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA 302:1872–9

    Article  PubMed  CAS  Google Scholar 

  • Langenberg AG, Corey L, Ashley RL, Leong WP, Straus SE (1999) A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group. N Engl J Med 341:1432–8

    Article  PubMed  CAS  Google Scholar 

  • Lorenzo ME, Hodgson A, Robinson DP, Kaplan JB, Pekosz A, Klein SL (2011) Antibody responses and cross protection against lethal influenza A viruses differ between the sexes in C57BL/6 mice. Vaccine 29:9246–55

    Article  PubMed  CAS  Google Scholar 

  • Lu FX, Abel K, Ma Z, Rourke T, Lu D, Torten J, McChesney M, Miller CJ (2002) The strength of B cell immunity in female rhesus macaques is controlled by CD8+ T cells under the influence of ovarian steroid hormones. Clin Exp Immunol 128:10–20

    Article  PubMed  CAS  Google Scholar 

  • Lucas GM, Chaisson RE, Moore RD (1999) Highly active antiretroviral therapy in a large urban clinic: risk factors for virologic failure and adverse drug reactions. Ann Intern Med 131:81–7

    PubMed  CAS  Google Scholar 

  • Ma WL, Hsu CL, Wu MH, Wu CT, Wu CC, Lai JJ, Jou YS, Chen CW, Yeh S, Chang C (2008) Androgen receptor is a new potential therapeutic target for the treatment of hepatocellular carcinoma. Gastroenterology 135:947–55, 955 e1–5

    Article  PubMed  CAS  Google Scholar 

  • Macdonald EM, Savoy A, Gillgrass A, Fernandez S, Smieja M, Rosenthal KL, Ashkar AA, Kaushic C (2007) Susceptibility of human female primary genital epithelial cells to herpes simplex virus, type-2 and the effect of TLR3 ligand and sex hormones on infection. Biol Reprod 77:1049–59

    Article  PubMed  CAS  Google Scholar 

  • Maltezou HC, Drakoulis N, Siahanidou T, Karalis V, Zervaki E, Dotsikas Y, Loukas YL, Theodoridou M (2011) Safety and pharmacokinetics of oseltamivir for prophylaxis of neonates exposed to influenza H1N1. Pediatr Infect Dis J 31:527–9

    Google Scholar 

  • Marriott I, Huet-Hudson YM (2006) Sexual dimorphism in innate immune responses to infectious organisms. Immunol Res 34:177–92

    Article  PubMed  CAS  Google Scholar 

  • Meditz AL, Mawhinney S, Allshouse A, Feser W, Markowitz M, Little S, Hecht R, Daar ES, Collier AC, Margolick J, Kilby JM, Routy JP, Conway B, Kaldor J, Levy J, Schooley R, Cooper DA, Altfeld M, Richman D, Connick E (2011) Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection. J Infect Dis 203:442–51

    Article  PubMed  Google Scholar 

  • Meier A, Chang JJ, Chan ES, Pollard RB, Sidhu HK, Kulkarni S, Wen TF, Lindsay RJ, Orellana L, Mildvan D, Bazner S, Streeck H, Alter G, Lifson JD, Carrington M, Bosch RJ, Robbins GK, Altfeld M (2009) Sex differences in the Toll-like receptor-mediated response of plasmacytoid dendritic cells to HIV-1. Nat Med 15:955–9

    Article  PubMed  CAS  Google Scholar 

  • Melgert BN, Oriss TB, Qi Z, Dixon-Mccarthy B, Geerlings M, Hylkema MN, Ray A (2010) Macrophages: regulators of sex differences in asthma? Am J Respir Cell Mol Biol 42:595–603

    Article  PubMed  CAS  Google Scholar 

  • Merrill RM, Beard JD (2009) Influenza vaccination in the United States, 2005–2007. Med Sci Monit 15:PH92–100

    PubMed  Google Scholar 

  • Mertz GJ, Benedetti J, Ashley R, Selke SA, Corey L (1992) Risk factors for the sexual transmission of genital herpes. Ann Intern Med 116:197–202

    PubMed  CAS  Google Scholar 

  • Moore AL, Mocroft A, Madge S, Devereux H, Wilson D, Phillips AN, Johnson M (2001) Gender differences in virologic response to treatment in an HIV-positive population: a cohort study. J Acquir Immune Defic Syndr 26:159–63

    Article  PubMed  CAS  Google Scholar 

  • Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, Scalia MR, Akinbami LJ, Centers for disease and Control and Prevention (2007) National surveillance for asthma – United States, 1980–2004. MMWR Surveill Summ 56:1–54

    PubMed  Google Scholar 

  • Morris CA, Oliver PR, Reynolds F, Selkon JB (1989) Intradermal hepatitis B immunization with yeast-derived vaccine: serological response by sex and age. Epidemiol Infect 103:387–94

    Article  PubMed  CAS  Google Scholar 

  • Murphy G, Pfeiffer R, Camargo MC, Rabkin CS (2009) Meta-analysis shows that prevalence of Epstein-Barr virus-positive gastric cancer differs based on sex and anatomic location. Gastroenterology 137:824–33

    Article  PubMed  Google Scholar 

  • Napravnik S, Poole C, Thomas JC, Eron JJ Jr (2002) Gender difference in HIV RNA levels: a meta-analysis of published studies. J Acquir Immune Defic Syndr 31:11–9

    Article  PubMed  CAS  Google Scholar 

  • Narciso-Schiavon JL, Schiavon Lde L, Carvalho-Filho RJ, Sampaio JP, Batah PN, Barbosa DV, Ferraz ML, Silva AE (2010) Gender influence on treatment of chronic hepatitis C genotype 1. Rev Soc Bras Med Trop 43:217–23

    Article  PubMed  Google Scholar 

  • Naugler WE, Sakurai T, Kim S, Maeda S, Kim K, Elsharkawy AM, Karin M (2007) Gender disparity in liver cancer due to sex differences in MyD88-dependent IL-6 production. Science 317:121–4

    Article  PubMed  CAS  Google Scholar 

  • Nguyen DC, Masseoud F, Lu X, Scinicariello F, Sambhara S, Attanasio R (2011) 17beta-Estradiol restores antibody responses to an influenza vaccine in a postmenopausal mouse model. Vaccine 29:2515–8

    Article  PubMed  CAS  Google Scholar 

  • Nichol KL, Margolis KL, Lind A, Murdoch M, Mcfadden R, Hauge M, Magnan S, Drake M (1996) Side effects associated with influenza vaccination in healthy working adults. A randomized, placebo-controlled trial. Arch Intern Med 156:1546–50

    Article  PubMed  CAS  Google Scholar 

  • Noymer A, Garenne M (2000) The 1918 influenza epidemic’s effects on sex differentials in mortality in the United States. Popul Dev Rev 26:565–581

    Article  PubMed  CAS  Google Scholar 

  • O’Leary DR, Marfin AA, Montgomery SP, Kipp AM, Lehman JA, Biggerstaff BJ, Elko VL, Collins PD, Jones JE, Campbell GL (2004) The epidemic of West Nile virus in the United States, 2002. Vector Borne Zoonotic Dis 4:61–70

    Article  PubMed  Google Scholar 

  • Obasi A, Mosha F, Quigley M, Sekirassa Z, Gibbs T, Munguti K, Todd J, Grosskurth H, Mayaud P, Changalucha J, Brown D, Mabey D, Hayes R (1999) Antibody to herpes simplex virus type 2 as a marker of sexual risk behavior in rural Tanzania. J Infect Dis 179:16–24

    Article  PubMed  CAS  Google Scholar 

  • Ofotokun I (2005) Sex differences in the pharmacologic effects of antiretroviral drugs: potential roles of drug transporters and phase 1 and 2 metabolizing enzymes. Top HIV Med 13:79–83

    PubMed  Google Scholar 

  • Ofotokun I, Chuck SK, Hitti JE (2007) Antiretroviral pharmacokinetic profile: a review of sex differences. Gend Med 4:106–19

    Article  PubMed  Google Scholar 

  • Ofotokun I, Pomeroy C (2003) Sex differences in adverse reactions to antiretroviral drugs. Top HIV Med 11:55–9

    PubMed  Google Scholar 

  • Oliveira W, Carmo E, Penna G, Kuchenbecker R, Santos H, Araujo W, Malaguti R, Duncan B, Schmidt M (2009) Pandemic H1N1 influenza in Brazil: analysis of the first 34,506 notified cases of influenza-like illness with severe acute respiratory infection (SARI). Euro Surveill 14:19362

    PubMed  Google Scholar 

  • Opstelten W, van Essen GA, Ballieux MJ, Goudswaard AN (2008) Influenza immunization of Dutch general practitioners: vaccination rate and attitudes towards vaccination. Vaccine 26:5918–21

    Article  PubMed  Google Scholar 

  • Pauklin S, Sernandez IV, Bachmann G, Ramiro AR, Petersen-Mahrt SK (2009) Estrogen directly activates AID transcription and function. J Exp Med 206:99–111

    Article  PubMed  CAS  Google Scholar 

  • Pinzan CF, Ruas LP, Casabona-Fortunato AS, Carvalho FC, Roque-Barreira MC (2010) Immunological basis for the gender differences in murine Paracoccidioides brasiliensis infection. PLoS One 5:e10757

    Article  PubMed  CAS  Google Scholar 

  • Poland GA, Ovsyannikova IG, Jacobson RM (2008) Personalized vaccines: the emerging field of vaccinomics. Expert Opin Biol Ther 8:1659–67

    Article  PubMed  CAS  Google Scholar 

  • Quinn TC, Overbaugh J (2005) HIV/AIDS in women: an expanding epidemic. Science 308:1582–3

    Article  PubMed  CAS  Google Scholar 

  • Qureshi AM, Hughes NJ, Murphy E, Primrose WR (2004) Factors influencing uptake of influenza vaccination among hospital-based health care workers. Occup Med (Lond) 54:197–201

    Article  CAS  Google Scholar 

  • Randolph AG, Vaughn F, Sullivan R, Rubinson L, Thompson BT, Yoon G, Smoot E, Rice TW, Loftis LL, Helfaer M, Doctor A, Paden M, Flori H, Babbitt C, Graciano AL, Gedeit R, Sanders RC, Giuliano JS, Zimmerman J, Uyeki TM (2011) Critically ill children during the 2009–2010 influenza pandemic in the United States. Pediatrics 128:e1450–8

    Article  PubMed  Google Scholar 

  • Reichman RC, Badger GJ, Guinan ME, Nahmias AJ, Keeney RE, Davis LG, Ashikaga T, Dolin R (1983) Topically administered acyclovir in the treatment of recurrent herpes simplex genitalis: a controlled trial. J Infect Dis 147:336–40

    Article  PubMed  CAS  Google Scholar 

  • Roberts CW, Walker W, Alexander J (2001) Sex-associated hormones and immunity to protozoan parasites. Clin Microbiol Rev 14:476–88

    Article  PubMed  CAS  Google Scholar 

  • Robinson DP, Lorenzo ME, Jian W, Klein SL (2011) Elevated 17beta-estradiol protects females from influenza a virus pathogenesis by suppressing inflammatory responses. PLoS Pathog 7:e1002149

    Article  PubMed  CAS  Google Scholar 

  • Robinson T, Bullen C, Humphries W, Hornell J, Moyes C (2005) The New Zealand Hepatitis B Screening Programme: screening coverage and prevalence of chronic hepatitis B infection. N Z Med J 118:U1345

    PubMed  Google Scholar 

  • Rodriguez-Torres M, Rios-Bedoya CF, Rodriguez-Orengo J, Fernandez-Carbia A, Marxuach-Cuetara AM, Lopez-Torres A, Salgado-Mercado R, Brau N (2006) Progression to cirrhosis in Latinos with chronic hepatitis C: differences in Puerto Ricans with and without human immunodeficiency virus coinfection and along gender. J Clin Gastroenterol 40:358–66

    Article  PubMed  Google Scholar 

  • Santibanez TA, Mootrey GT, Euler GL, Janssen AP (2010) Behavior and beliefs about influenza vaccine among adults aged 50–64 years. Am J Health Behav 34:77–89

    Article  PubMed  Google Scholar 

  • Schatz M, Camargo CA Jr (2003) The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization. Ann Allergy, Asthma Immunol 91:553–558, Official Publication of the American College of Allergy, Asthma, & Immunology

    Article  Google Scholar 

  • Schatz M, Clark S, Camargo CA Jr (2006) Sex differences in the presentation and course of asthma hospitalizations. Chest 129:50–55

    Article  PubMed  Google Scholar 

  • Schott E, Witt H, Hinrichsen H, Neumann K, Weich V, Bergk A, Halangk J, Muller T, Tinjala S, Puhl G, Neuhaus P, Wiedenmann B, Berg T (2007) Gender-dependent association of CTLA4 polymorphisms with resolution of hepatitis C virus infection. J Hepatol 46:372–80

    Article  PubMed  CAS  Google Scholar 

  • Schwarzinger M, Flicoteaux R, Cortarenoda S, Obadia Y, Moatti JP (2010) Low acceptability of A/H1N1 pandemic vaccination in French adult population: did public health policy fuel public dissonance? PLoS One 5:e10199

    Article  PubMed  CAS  Google Scholar 

  • Sedyaningsih ER, Isfandari S, Setiawaty V, Rifati L, Harun S, Purba W, Imari S, Giriputra S, Blair PJ, Putnam SD, Uyeki TM, Soendoro T (2007) Epidemiology of cases of H5N1 virus infection in Indonesia, July 2005–June 2006. J Infect Dis 196:522–7

    Article  PubMed  Google Scholar 

  • Siddiqui RA, Sauermann U, Altmuller J, Fritzer E, Nothnagel M, Dalibor N, Fellay J, Kaup FJ, Stahl-Hennig C, Nurnberg P, Krawczak M, Platzer M (2009) X chromosomal variation is associated with slow progression to AIDS in HIV-1-infected women. Am J Hum Genet 85:228–39

    Article  PubMed  CAS  Google Scholar 

  • Singh AK, Cydulka RK, Stahmer SA, Woodruff PG, Camargo CA Jr (1999) Sex differences among adults presenting to the emergency department with acute asthma. Multicenter Asthma Research Collaboration Investigators. Arch Intern Med 159:1237–1243

    Article  PubMed  CAS  Google Scholar 

  • Stanberry LR, Spruance SL, Cunningham AL, Bernstein DI, Mindel A, Sacks S, Tyring S, Aoki FY, Slaoui M, Denis M, Vandepapeliere P, Dubin G (2002) Glycoprotein-D-adjuvant vaccine to prevent genital herpes. N Engl J Med 347:1652–61

    Article  PubMed  CAS  Google Scholar 

  • Stephenson J (2000) Genital herpes vaccine shows limited promise. JAMA 284:1913–4

    Article  PubMed  CAS  Google Scholar 

  • Sterling TR, Vlahov D, Astemborski J, Hoover DR, Margolick JB, Quinn TC (2001) Initial plasma HIV-1 RNA levels and progression to AIDS in women and men. N Engl J Med 344:720–5

    Article  PubMed  CAS  Google Scholar 

  • Straus SE, Corey L, Burke RL, Savarese B, Barnum G, Krause PR, Kost RG, Meier JL, Sekulovich R, Adair SF et al (1994) Placebo-controlled trial of vaccination with recombinant glycoprotein D of herpes simplex virus type 2 for immunotherapy of genital herpes. Lancet 343:1460–3

    Article  PubMed  CAS  Google Scholar 

  • Szretter KJ, Gangappa S, Lu X, Smith C, Shieh WJ, Zaki SR, Sambhara S, Tumpey TM, Katz JM (2007) Role of host cytokine responses in the pathogenesis of avian H5N1 influenza viruses in mice. J Virol 81:2736–44

    Article  PubMed  CAS  Google Scholar 

  • Teichmann J, Schmidt A, Lange U, Stracke H, Discher T, Friese G, Lohmeyer J, Bretzel RG (2003) Longitudinal evaluation of serum estradiol and estrone in male patients infected with the human immunodeficiency virus. Eur J Med Res 8:77–80

    PubMed  CAS  Google Scholar 

  • Theiler RN, Rasmussen SA, Treadwell TA, Jamieson DJ (2008) Emerging and zoonotic infections in women. Infect Dis Clin North Am 22:755–72

    Article  PubMed  Google Scholar 

  • Theng TS, Chan RK (2004) Genital herpes in a sexually-transmitted infection clinic in Singapore: a 1-year retrospective study. Ann Acad Med Singapore 33:200–3

    PubMed  CAS  Google Scholar 

  • Tian Y, Kuo CF, Chen WL, Ou JH (2012) Enhancement of hepatitis B virus replication by androgen and its receptor in mice. J Virol 86:1904–10

    Article  PubMed  CAS  Google Scholar 

  • Tsay PK, Tai DI, Chen YM, Yu CP, Wan SY, Shen YJ, Lin DY (2009) Impact of gender, viral transmission and aging in the prevalence of hepatitis B surface antigen. Chang Gung Med J 32:155–64

    PubMed  Google Scholar 

  • Vicetti Miguel RD, Sheridan BS, Harvey SA, Schreiner RS, Hendricks RL, Cherpes TL (2010) 17-beta estradiol promotion of herpes simplex virus type 1 reactivation is estrogen receptor dependent. J Virol 84:565–72

    Article  PubMed  CAS  Google Scholar 

  • Villa E, Karampatou A, Camma C, di Leo A, Luongo M, Ferrari A, Petta S, Losi L, Taliani G, Trande P, Lei B, Graziosi A, Bernabucci V, Critelli R, Pazienza P, Rendina M, Antonelli A, Francavilla A (2011) Early menopause is associated with lack of response to antiviral therapy in women with chronic hepatitis C. Gastroenterology 140:818–29

    Article  PubMed  Google Scholar 

  • Villacres MC, Longmate J, Auge C, Diamond DJ (2004) Predominant type 1 CMV-specific memory T-helper response in humans: evidence for gender differences in cytokine secretion. Hum Immunol 65:476–85

    Article  PubMed  CAS  Google Scholar 

  • Wald A (2004) Herpes simplex virus type 2 transmission: risk factors and virus shedding. Herpes 11(Suppl 3):130A–137A

    PubMed  Google Scholar 

  • Wang SH, Yeh SH, Lin WH, Wang HY, Chen DS, Chen PJ (2009) Identification of androgen response elements in the enhancer I of hepatitis B virus: a mechanism for sex disparity in chronic hepatitis B. Hepatology 50:1392–402

    Article  PubMed  CAS  Google Scholar 

  • White DJ, Means RG, Birkhead GS, Bosler EM, Grady LJ, Chatterjee N, Woodall J, Hjelle B, Rollin PE, Ksiazek TG, Morse DL (1996) Human and rodent hantavirus infection in New York State: public health significance of an emerging infectious disease. Arch Intern Med 156:722–6

    Article  PubMed  CAS  Google Scholar 

  • Wikby A, Mansson IA, Johansson B, Strindhall J, Nilsson SE (2008) The immune risk profile is associated with age and gender: findings from three Swedish population studies of individuals 20–100 years of age. Biogerontology 9:299–308

    Article  PubMed  Google Scholar 

  • Williams RJ, Bryan RT, Mills JN, Palma RE, Vera I, de Velasquez F, Baez E, Schmidt WE, Figueroa RE, Peters CJ, Zaki SR, Khan AS, Ksiazek TG (1997) An outbreak of hantavirus pulmonary syndrome in western Paraguay. Am J Trop Med Hyg 57:274–82

    PubMed  CAS  Google Scholar 

  • Wingard DL (1984) The sex differential in morbidity, mortality, and lifestyle. Annu Rev Public Health 5:433–58

    Article  PubMed  CAS  Google Scholar 

  • Xia HJ, Zhang GH, Wang RR, Zheng YT (2009) The influence of age and sex on the cell counts of peripheral blood leukocyte subpopulations in Chinese rhesus macaques. Cell Mol Immunol 6:433–40

    Article  PubMed  Google Scholar 

  • Yu JW, Sun LJ, Zhao YH, Kang P, Yan BZ (2011) Impact of sex on virologic response rates in genotype 1 chronic hepatitis C patients with peginterferon alpha-2a and ribavirin treatment. Int J Infect Dis 15:e740–6

    Article  PubMed  CAS  Google Scholar 

  • Yu MW, Cheng SW, Lin MW, Yang SY, Liaw YF, Chang HC, Hsiao TJ, Lin SM, Lee SD, Chen PJ, Liu CJ, Chen CJ (2000) Androgen-receptor gene CAG repeats, plasma testosterone levels, and risk of hepatitis B-related hepatocellular carcinoma. J Natl Cancer Inst 92:2023–8

    Article  PubMed  CAS  Google Scholar 

  • Yu MW, Yang YC, Yang SY, Cheng SW, Liaw YF, Lin SM, Chen CJ (2001) Hormonal markers and hepatitis B virus-related hepatocellular carcinoma risk: a nested case–control study among men. J Natl Cancer Inst 93:1644–51

    Article  PubMed  CAS  Google Scholar 

  • Zarychanski R, Stuart TL, Kumar A, Doucette S, Elliott L, Kettner J, Plummer F (2010) Correlates of severe disease in patients with 2009 pandemic influenza (H1N1) virus infection. CMAJ 182:257–64

    Article  PubMed  Google Scholar 

  • Zeeshan M, Jabeen K, Ali AN, Ali AW, Farooqui SZ, Mehraj V, Zafar A (2007) Evaluation of immune response to Hepatitis B vaccine in health care workers at a tertiary care hospital in Pakistan: an observational prospective study. BMC Infect Dis 7:120

    Article  PubMed  CAS  Google Scholar 

  • Zhang X, Castelli FA, Zhu X, Wu M, Maillere B, Benmohamed L (2008) Gender-dependent HLA-DR-restricted epitopes identified from herpes simplex virus type 1 glycoprotein D. Clin Vaccine Immunol 15:1436–49

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sabra L. Klein .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Klein, S.L. (2013). Sex Differences in Prophylaxis and Therapeutic Treatments for Viral Diseases. In: Regitz-Zagrosek, V. (eds) Sex and Gender Differences in Pharmacology. Handbook of Experimental Pharmacology, vol 214. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30726-3_22

Download citation

Publish with us

Policies and ethics