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

Bioessays. 2012 Dec;34(12):1050-9. doi: 10.1002/bies.201200099. Epub 2012 Sep 26.


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. Editor's suggested further reading in BioEssays X-chromosome-located microRNAs in immunity: Might they explain male/female differences Abstract.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptive Immunity
  • Animals
  • Antibody Formation / immunology*
  • Antiviral Agents / adverse effects
  • Antiviral Agents / pharmacology*
  • Female
  • Genes, MHC Class II
  • HIV Infections / drug therapy
  • HIV Infections / immunology
  • HIV Infections / virology
  • Hepatitis B / drug therapy
  • Hepatitis B / immunology
  • Hepatitis C / drug therapy
  • Hepatitis C / immunology
  • Herpes Simplex / drug therapy
  • Herpes Simplex / immunology
  • Humans
  • Immunity, Innate
  • Male
  • Sex Characteristics
  • Sex Factors
  • Treatment Outcome
  • Vaccination
  • Viral Load
  • Viral Vaccines / immunology*
  • Virus Diseases / drug therapy
  • Virus Diseases / immunology*


  • Antiviral Agents
  • Viral Vaccines