A Sex-Stratified Analysis of Monocyte Phenotypes Associated with HIV Infection in Uganda

Viruses. 2021 Oct 22;13(11):2135. doi: 10.3390/v13112135.


Women with HIV may experience higher rates of non-AIDS comorbidities compared to men with HIV, but the underlying mechanisms are not well understood. We investigated sex-related differences in the effects of HIV on monocyte phenotypes within the Ugandan Study of HIV effects on the Myocardium and Atherosclerosis (mUTIMA). Of 133 participants who provided blood for flow cytometry assays, 86 (65%) were women and 91 (68%) were persons living with HIV (PLWH) on antiretroviral therapy. The median age was 57 (interquartile range, 52-63) years. PLWH exhibited a lower proportion of circulating CD14+CD16- classical monocytes (66.3% vs. 75.1%; p < 0.001), and higher proportion of CD14+CD16+ inflammatory monocytes (17% vs. 11.7%; p = 0.005) compared to HIV-uninfected participants. PLWH had an increased expression of the chemokine receptor CX3CR1 in total monocytes (CX3CR1+ monocytes, 24.5% vs. 4.7%; p < 0.001) and monocyte subsets. These findings were generally similar when analyzed by sex, with no significant interactions between sex and HIV status in adjusted models. Our data show that the inflammatory monocyte subset is expanded and monocyte CX3CR1 chemokine receptor expression is enhanced among PLWH, regardless of sex. Whether these parameters differentially affect risk for non-AIDS comorbidities and clinical outcomes in women with HIV requires additional investigation.

Keywords: HIV; activation; inflammation; monocytes; sex; women.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • CX3C Chemokine Receptor 1 / metabolism
  • Cross-Sectional Studies
  • Female
  • Flow Cytometry
  • GPI-Linked Proteins
  • HIV Infections* / drug therapy
  • Humans
  • Inflammation
  • Lipopolysaccharide Receptors
  • Male
  • Middle Aged
  • Monocytes / metabolism*
  • Phenotype*
  • Receptors, Chemokine / genetics
  • Receptors, IgG
  • Uganda


  • CD14 protein, human
  • CX3C Chemokine Receptor 1
  • CX3CR1 protein, human
  • FCGR3B protein, human
  • GPI-Linked Proteins
  • Lipopolysaccharide Receptors
  • Receptors, Chemokine
  • Receptors, IgG