A global approach to HIV‐1 vaccine development. Issue 1 (16th June 2013)

• Record Type: Journal Article
• Authors: Stephenson, Kathryn E.; Barouch, Dan H.
• Is Part Of: Immunological reviews. Volume 254:Issue 1(2013:Jul.)
• Page Start: 295
• Page End: 304
• Publication Date: 2013-06-16
• Subjects: HIV -- vaccines -- viral diversity -- immune responses; Immunology -- Periodicals; Transplantation of organs, tissues, etc -- Periodicals; 616.079
• DOI: 10.1111/imr.12073
• Languages: English
• ISSNs: 0105-2896

Abstract

Summary: A global human immunodeficiency virus‐1 (HIV‐1) vaccine will have to elicit immune responses capable of providing protection against a tremendous diversity of HIV‐1 variants. In this review, we first describe the current state of the HIV‐1 vaccine field, outlining the immune responses that are desired in a global HIV‐1 vaccine. In particular, we emphasize the likely importance of Env‐specific neutralizing and non‐neutralizing antibodies for protection against HIV‐1 acquisition and the likely importance of effector Gag‐specific T lymphocytes for virologic control. We then highlight four strategies for developing a global HIV‐1 vaccine. The first approach is to design specific vaccines for each geographic region that include antigens tailor‐made to match local circulating HIV‐1 strains. The second approach is to design a vaccine that will elicit Env‐specific antibodies capable of broadly neutralizing all HIV‐1 subtypes. The third approach is to design a vaccine that will elicit cellular immune responses that are focused on highly conserved HIV‐1 sequences. The fourth approach is to design a vaccine to elicit highly diverse HIV‐1‐specific responses. Finally, we emphasize the importance of conducting clinical efficacy trials as the only way to determine which strategies will provide optimal protection against HIV‐1 in humans.