Important note: Information in this article was accurate in December 1999. The state of the art may have changed since the publication date.
Experts believe that subunit vaccines may best be used as part of a "prime-boost" combination vaccine strategy. A vaccine such as a powerful avian pox vector would serve as the "prime" by sparking an adequate CTL response; soluble HIV proteins (the "boost") would then be used to stimulate neutralizing antibodies. The order in which prime and boost are given, as well as the sequence of injection routes, seem to affect the strength of immune responses. For example, a report in the February 1999 issue of Vaccine stated that administering a DNA vaccine first as an intramuscular prime then as a gene gun boost induced CTLs more efficiently than vice versa. (A single vaccine may serve as both prime and boost.)
One advantage of the prime-boost method is its potential to induce memory CTLs and Th1 CD4 cells, necessary components in a fully functioning immune system. Memory T-lymphocytes can mobilize rapidly and clone themselves if a specific antigen, encountered during infection or vaccination, appears at a later time.
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