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Review
. 2020 Jan 16;38(3):411-415.
doi: 10.1016/j.vaccine.2019.11.011. Epub 2019 Nov 21.

Immunological mechanisms of inducing HIV immunity in infants

Genevieve G Fouda  1 , Kristina De Paris  2 , Ofer Levy  3 , Arnaud Marchant  4 , Glenda Gray  5 , Sallie Permar  6 , Mary Marovich  7 , Anjali Singh  7
Affiliations
Review

Immunological mechanisms of inducing HIV immunity in infants

Genevieve G Fouda et al. Vaccine. .

Abstract

The potential advantages and unique challenges of the early life immune system for the development of HIV-specific broadly neutralizing antibodies were discussed during a workshop entitled "Immunological Mechanisms of Inducing HIV Immunity in Infants" sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) in conjunction with the 2018 HIVR4P Conference held in Madrid, Spain. A safe and effective HIV vaccine remains a critical need in the fight against the HIV pandemic, especially to prevent emerging infections in infants, adolescents, and young adults. To successfully target these populations, a vaccine should ideally induce protective immune responses during childhood. Interestingly, several recent studies highlighting differences in immune responses between adults and children have suggested that the early life immune system could present advantages for the elicitation of broadly neutralizing antibodies (bnAbs), a response highly desired for an HIV vaccine. Notably, HIV-infected children develop bnAbs responses earlier and more frequently than infected adults; with emerging evidence that the pathways of elicitation of bnAb lineages may differ between adults and children. Moreover, there is precedent for the prevention of lifelong infections with pediatric immunization, and early life provides a unique window of opportunity for the administration of a multi-dose HIV vaccine that will likely be needed to achieve protective immunity. Further understanding of how the distinct early life immune system can be harnessed to trigger bnAb lineages for induction of durable and polyfunctional HIV-specific immunity is warranted. This strategy will include testing promising HIV vaccine candidates in pediatric populations in preclinical and clinical studies. Novel approaches to identify molecular markers of protection are also key to guide and accelerate pediatric HIV vaccine development.

Keywords: Broadly neutralizing antibodies; Early life; HIV; Immune system; Vaccine.

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Conflict of interest statement

CONFLICTS OF INTEREST

Dr. Ofer Levy is a named inventor on several vaccine adjuvant patents. Dr. Sallie Permar serves as a consultant for Moderna, Merck, Sanofi, and Pfizer vaccines and leads sponsored programs from Merck and Moderna. All other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Summary of factors that could contribute to regulate the development of HIV specific broadly neutralizing antibody lineages in the setting of the early life immune system
See this image and copyright information in PMC

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