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Max V. Kuenstling

, Eric J. Benner

, and R. Lee Mosley

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date: 07 July 2020

The ultimate goal of vaccination is to deliver effective immunity that, under conditions of disease exposure, either prevents infection or allows rapid clearance of infected cells. However, developing an effective vaccine for HIV-1 is fraught with difficulties. A major challenge is the speed with which HIV-1 incorporates its genomic information into host DNA in the form of a relatively inaccessible latent provirus. Other challenges include the (to date) inability of vaccines to elicit adequate neutralizing antibodies in humans; difficulties in finding adequate small-animal models for vaccine research; and the threat that an otherwise-effective vaccine would, by stimulating an immune response in the brain, itself exacerbate the inflammatory activation that appears to play a central role in the neuropathogenesis of HIV-1 infection. This chapter aims to provide an understanding of the challenges that have impeded the development of a successful HIV vaccine, and to describe some potentially effective strategies that may ultimately provide at least some clinically important level of vaccine protection. As part of the presentation, the results of clinical vaccine trials are discussed.

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