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Vaccines for The Prevention and Treatment of HIV Infection 

Vaccines for The Prevention and Treatment of HIV Infection
Chapter:
Vaccines for The Prevention and Treatment of HIV Infection
Author(s):

Josephine H. Cox

, Stuart Z. Shapiro

, Liza Dawson

, Cynthia Geppert

, Andrew M. Siegel

, and M. Patricia D’Souza

DOI:
10.1093/med/9780199392742.003.0032
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date: 18 August 2019

While the HIV/AIDS pandemic continues, the overall incidence of HIV infections has fallen through use of antiretroviral therapy (ART) and multiple prevention modalities. To achieve a durable end to the pandemic and avoid the requirement for daily antiretroviral medication over a lifetime, a safe and effective prophylactic vaccine remains essential. This chapter reviews current advances in prophylactic and therapeutic HIV-1 vaccine strategies and the challenges that lie ahead. Recent success in isolation of potent broadly neutralizing antibodies (bnAbs) from infected individuals, the discovery of mechanisms of bnAb induction, and progress in understanding mechanisms of CD8 T-cell killing of HIV-infected cells and the structure of the HIV envelope trimer have opened new strategies for HIV vaccine design. On the therapeutic front, the persistence of HIV reservoirs remains a formidable obstacle to achieving sustained virological remission in HIV-infected individuals after ART is discontinued. Development of a new generation of immune-based therapeutic agents might contribute to a curative intervention. The chapter closes with an overview of ethical challenges in vaccine development and clinical testing.

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