Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
PROPHYLACTIC AND THERAPEUTIC IMMUNIZATION AGAINST AIDS: THEORETICAL CONSIDERATIONS UNDERLYING A MODIFIED NONINFECTIOUS WHOLE VIRUS APPROACH
AIDS Vaccine Research and Clinical Trials. Putney SD and Bolognesi DP, eds. New York, Marcel Dekker, p. 265-75, 1990.. Unique Identifier : AIDSLINE ICDB/91676951 Salk J; Gersten MJ; The Salk Inst. for Biological Studies, San Diego, CA
Abstract:
Post-HIV infection events may be modulated by (1) prepriming the immune system by active immunization of HIV seronegatives, to respond anamnestically to subsequent HIV exposure, to prevent establishment of infection and/or disease or (2) through active and/or passive immunization of HIV seropositives, to prevent, arrest, or reverse the development of disease by limiting already established infection. These hypotheses are testable using an HIV immunogen consisting of native HIV molecules present in a purified and concentrated preparation of tissue culture-adapted HIV that is treated to destroy infectivity, depleted of the outer envelope glycoprotein gp210, and incorporated into a suitable potent immunologic adjuvant. Studies of the noninfectious whole-virus approach to AIDS management are reviewed. In view of humoral response patterns observed in seropositive chimpanzees and the absence of toxicity, exploratory toxicity and immunogenicity studies were initiated in virus culture-positive HIV-seropositive individuals with persistent generalized lymphadenopathy. Seropositive individuals (19) did not show anamnestic humoral responses, but there was some effect on some components of the immune system, because delayed-type hypersensitivity (DTH) responsiveness to nonspecific antigens developed in some who initially were anergic and increased in others. CD4 cell levels, compared with historical control data for the same individuals, tended to be maintained stably during a year postimmunization. Further observations in humans have suggested that the presence of HIV-specific DTH, unrelated to the presence or absence of nonspecific DTH, plays a significant role in retarding the rate of progression of the HIV infection. These studies suggest that a multiple-strategy approach in which prophylactic immunization is used in at-risk seronegative individuals and therapeutic immunization is used in symptomatic and asymptomatic seropositives. Active immunization should be studied in seronegatives and in seropositives sufficiently immunocompetent to mount an immune response. For more severely immunocompromised seropositives, passive immunization with IgG needs to be explored. For treating newborns of HIV-infected mothers, passive + active immunization would be appropriate. (18 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*PREVENTION & CONTROL Animal CD4-Positive T-Lymphocytes/IMMUNOLOGY Human HIV/*IMMUNOLOGY HIV Antibodies/*BIOSYNTHESIS HIV Antigens/IMMUNOLOGY HIV Envelope Protein gp120/IMMUNOLOGY HIV Seropositivity/IMMUNOLOGY Vaccines, Synthetic/*ADMINISTRATION & DOSAGE Viral Vaccines/*ADMINISTRATION & DOSAGE MONOGRAPH REVIEW 912130
M91C4091
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
