Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
APPROACHES TO VACCINES FOR HIV: PROBLEMS AND PROSPECTS
AIDS in Children, Adolescents, and Heterosexual Adults: An Interdisciplinary Approach to Prevention. Schinazi RF, Nahmias AJ, eds. New York, Elsevier, p. 144-9, 1988.. Unique Identifier : AIDSLINE ICDB/89649788 Katz SL; Dept. of Pediatrics, Duke Univ. Medical Center, Durham, NC
Abstract:
There is no accumulated experience with vaccines for human retroviruses. The only animal retrovirus experience is controversial and concerns only feline leukemia virus. The historical background of vaccine development and other aspects of vaccines are discussed in relation to development of a vaccine for HIV. There is little prospect for developing a vaccine to prevent AIDS in an HIV-positive person. That represents the end stage of infection. Interest is confined primarily to prevention of infection with HIV before the virus establishes its state of latency. For successful protection against HIV infection, any vaccine would have to be administered at a very young age, before the onset of sexual activity or drug-abusing behavior commences. In addition, the impressive successes of conventional vaccines have almost all been obtained with children. The author discusses potential pediatric candidates for HIV immunization include asymptomatic HIV-infected children, children with AIDS or AIDS-related complex, newborns of HIV-infected mothers, children in high-risk groups, and all infants. Controversial issues of cost, virus effectiveness, and management of an immunization program must be dealt with in development of a successful program. Steps in the development of AIDS vaccine are isolation of the responsible agent, elucidation of disease natural history and pathogenesis, identification of an animal model, development of candidate vaccines, testing vaccines in the animal model, and studies in humans (Phases 1, 2, and 3, and post-licensure surveillance). The first of these has been accomplished, but the rest present significant problems. Approaches to AIDS vaccines include inactivated whole virus, subunits (peptides, glycoproteins, or conserved epitopes), recombinant viral vector, synthetic polypeptides, anti-idiotypes, live virus preparations, and possibly passive immunization. It will be a long time before vaccines are developed and tested. Present efforts must focus on other interdisciplinary approaches to prevention. (5 Refs)
Keywords: Acquired Immunodeficiency Syndrome/IMMUNOLOGY/*PREVENTION & CONTROL Adult Child Human HIV/*IMMUNOLOGY Infant Infant, Newborn Risk Factors Vaccination Viral Vaccines/*ADMINISTRATION & DOSAGE/IMMUNOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
