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Review
. 2008 Oct 2;455(7213):613-9.
doi: 10.1038/nature07352.

Challenges in the development of an HIV-1 vaccine

Dan H Barouch  1
Affiliations
Review

Challenges in the development of an HIV-1 vaccine

Dan H Barouch. Nature. .

Abstract

The development of a safe and effective human immunodeficiency virus (HIV)-1 vaccine is a critically important global health priority. Despite recent advances in our understanding of HIV-1 pathogenesis and immunology, however, major scientific obstacles remain. Prototype HIV-1 vaccine candidates aimed at eliciting humoral and cellular immune responses have so far failed to protect against HIV-1 infection or to reduce viral loads after infection in clinical efficacy studies. A renewed and coordinated commitment to basic discovery research, preclinical studies and clinical trials will therefore be required to overcome the hurdles currently facing the field. Here I review key challenges and future prospects in the quest to develop a prophylactic HIV-1 vaccine.

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Figures

Figure 1
Figure 1. Goals of an HIV-1 vaccine
Following infection, HIV-1 replicates exponentially to a peak level and then is partially controlled to a viral setpoint level (black). Left, an ideal vaccine would protect against infection and afford sterilizing immunity (red). Right, a suboptimal vaccine would result in decreased peak and setpoint viral loads following infection (red).
Figure 2
Figure 2. Cumulative HIV-1 infections in men enrolled in the STEP study as stratified by pre-existing Ad5-specific NAb titer
Cumulative infections as of October 17, 2007 in men enrolled in the STEP study (HVTN 502) evaluating the Merck rAd5-Gag/Pol/Nef vaccine are depicted. Infections in vaccinees (red) and placebos (blue) are shown in individuals as stratified by pre-existing Ad5-specific NAb titers. Data represent the modified intent-to-treat population. Courtesy of Dr. Michael Robertson, Merck Research Laboratories.
See this image and copyright information in PMC

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