Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
VACCINES AGAINST AIDS: I. AN OVERVIEW OF APPROACHES TO VACCINATION AGAINST AIDS
New Generation Vaccines. Woodrow GC and Levine MM, eds. New York, Marcel Dekker, p. 741-53, 1990.. Unique Identifier : AIDSLINE ICDB/92678614 Tacket CO; Center for Vaccine Development, Dept. of Medicine, Univ. of; Maryland Sch. of Medicine, Baltimore, MD
Abstract:
AIDS has taxed the abilities of basic scientists, physicians, and epidemiologists, who have described the etiologic agent, clinical spectrum, and modes of transmission. For AIDS vaccine development, gaps in knowledge about both pathogenesis and the protective immune response hinder the design of a vaccine. HIV-1 infection and some strategies and problems related to vaccine development are reviewed under the following headings: HIV-1 and the immune response to HIV-1 (humoral and cellular immune responses); strategies toward AIDS vaccine development (whole virus subunit vaccines, live virus vectors, and anti-idiotype vaccines); and problems in AIDS vaccine development (HIV-1 heterogeneity, cell-to-cell transmission of HIV-1, potential vaccine-induced immunopathology, animal models for preclinical testing, and issues related to clinical study design). A major obstacle confronting preclinical testing is the lack of a suitable animal model. Although the chimpanzee becomes infected with HIV-1 after iv inoculation and develops antibody and T-cell responses, no chimpanzee has developed immunodeficiency after several years of observation. Phase 1 studies of candidate AIDS vaccines, including cloned gp160, a vaccinia/gp160 recombinant, and killed HIV-1 vaccine, recently have begun amid a still unresolved debate about whether volunteer studies should proceed without more encouraging animal protection data. For trials in at-risk populations to proceed successfully, new diagnostic tests of HIV-1 infection that do not depend on antibody will have to be developed to clearly distinguish vaccinees from infected individuals. Despite the multitude of obstacles, AIDS vaccine development has progressed. There is reason for some optimism because another retroviral disease, feline leukemia, has been prevented by vaccination. The problem of strain heterogeneity among HIV-1 isolates may become less of a problem if conserved epitopes are both immunogenic and protective or if there is a limited number of serotypes of HIV-1. The macaque-simian immunodeficiency virus (SIV) model offers hope for a practical way to predict the efficacy of HIV-1 virus vaccine candidates based on studies of analogous SIV vaccine candidates. (90 Refs)
Keywords: Animal Antibody-Dependent Cell Cytotoxicity/IMMUNOLOGY AIDS Vaccines/*ADMINISTRATION & DOSAGE/*IMMUNOLOGY Human HIV Antibodies/BIOSYNTHESIS HIV Antigens/IMMUNOLOGY HIV Infections/*IMMUNOLOGY/*PREVENTION & CONTROL HIV-1/*IMMUNOLOGY Killer Cells, Natural/IMMUNOLOGY T-Lymphocytes, Cytotoxic/IMMUNOLOGY Vaccines, Synthetic/*ADMINISTRATION & DOSAGE/*IMMUNOLOGY MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
