Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
STRATEGIES FOR THE DEVELOPMENT OF VACCINES TO PREVENT AIDS
AIDS: Etiology, Diagnosis, Treatment, and Prevention. Second Edition. DeVita VT Jr et al, eds. Philadelphia, Lippincott, p. 87-104, 1988.. Unique Identifier : AIDSLINE ICDB/89650902 Fischinger PJ; NCI, Bethesda, MD
Abstract:
Human AIDS is an expanding pandemic involving over 57,000 cases in the United States alone. As currently defined, clinical AIDS is generally lethal. Infection with the causative agent, HIV, is apparently irreversible. Current strategies of intervention are based on a few drugs of the chain terminating family that lessen the probability of progression to further serious events in patients who already have AIDS. Because there do not appear to be any clearly defined individuals who have been initially infected but have either eliminated or adequately controlled the HIV infection, preventative approaches that involve vaccine strategies appear to be critically important. Prioritizing vaccine strategies, choice of a viral target, intrinsic difficulties, strategies for broadening the immune response, animal models for determining the protective capacity of HIV vaccines, challenge experiments with infectious HIV, and decision making during the vaccine testing process are considered. The major acknowledged problem appears to be the extensive heterogeneity of HIV isolates. In the more than 100 separate isolates, only a few closely matched pairs were observed, and some of these were isolated contemporaneously. Animal models will be useful to determine the protective capacity of HIV vaccines. Chimpanzee is the only species that can be infected readily with several of the HIV isolates tested, but only several hundred animals may be available for vaccine purposes worldwide. The scarcity of the chimpanzee could dictate that only critical experiments be carried out in this species. There are two possible outcomes if a given vaccine proves efficacious. If primary infection with HIV could be prevented in man by vaccine, then further steps to larger-scale efficacy testing would be rapid. If prevention of infection is not feasible, but prevention of disease occurs, the plan for development of a vaccine would have to span a number of years because of the length of time between exposure and disease. In the latter case, multiple trials might be initiated to produce a better preparation that could prevent the primary HIV infection. This biphasic approach may run concurrently. (81 Refs)
Keywords: Acquired Immunodeficiency Syndrome/IMMUNOLOGY/*PREVENTION & CONTROL Animal Chimpansee troglodytes Human HIV/*IMMUNOLOGY HIV Antibodies/BIOSYNTHESIS HIV Antigens/IMMUNOLOGY Neutralization Tests Receptors, Virus/IMMUNOLOGY Retroviridae Proteins/IMMUNOLOGY Vaccines, Attenuated/ADMINISTRATION & DOSAGE Vaccines, Inactivated/ADMINISTRATION & DOSAGE Vaccines, Synthetic/ADMINISTRATION & DOSAGE 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.
