Therapeutic immunization strategies for the control of HIV-1.
Dorrell L.
Highly active antiretroviral therapy (HAART) is currently the only means to halt or prevent progression to AIDS. However, lack of access to medications for the vast majority of HIV-1-infected individuals in immediate need, together with the requirement for lifelong adherence and potential for serious toxicity, are significant limitations which have yet to be overcome. Augmentation of HIV-specific immunity by therapeutic vaccination is being explored as a possible alternative to continuous HAART. A few candidate HIV-1 vaccines have entered clinical trials involving an assessment of viremia control during an analytic therapy interruption, but even the most promising of these achieve a short-lived suppression of HIV-1 without HAART. Nevertheless, these studies are guiding the development of better immune augmentation strategies, which could extend the time off therapy and will also contribute to a better understanding of the immune correlates of protection against AIDS. The status of therapeutic vaccines that are currently undergoing preclinical and clinical evaluation is reviewed.