Sex differences in tuberculosis

Semin Immunopathol. 2019 Mar;41(2):225-237. doi: 10.1007/s00281-018-0725-6. Epub 2018 Oct 25.

Abstract

Tuberculosis is the most prevalent bacterial infectious disease in humans and the leading cause of death from a single infectious agent, ranking above HIV/AIDS. The causative agent, Mycobacterium tuberculosis, is carried by an estimated two billion people globally and claims more than 1.5 million lives each year. Tuberculosis rates are significantly higher in men than in women, reflected by a male-to-female ratio for worldwide case notifications of 1.7. This phenomenon is not new and has been reported in various countries and settings over the last century. However, the reasons for the observed gender bias are not clear, potentially highly complex and discussed controversially in the literature. Both gender- (referring to sociocultural roles and behavior) and sex-related factors (referring to biological aspects) likely contribute to higher tuberculosis rates in men and will be discussed.

Keywords: Inflammation; Male bias; Mouse models; Sex differences; Susceptibility; Tuberculosis.

Publication types

  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / epidemiology
  • Acquired Immunodeficiency Syndrome / immunology
  • Female
  • Humans
  • Male
  • Mycobacterium tuberculosis / immunology*
  • Sex Characteristics*
  • Tuberculosis / epidemiology
  • Tuberculosis / immunology*