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July 29, 2002
U.S. IMMUNIZATION NEWS
"Strategies for an HIV Vaccine"
Journal of Clinical Investigation Online (www.jci.org) (07/01/02)
Vol. 110, No. 1, P. 15; Letvin, Norman L.
In a review of the information available concerning the
development of an AIDS vaccine, Dr. Norman L. Letvin of Harvard
Medical School points out that the development of such a vaccine
is elusive given the genetic make-up of several different strains
of HIV. The strains are geologically varied, but the big problem
is their genetic characteristics, with some experts believing
that each separate area, with its different strain, will need a
unique vaccine to combat the virus. In addition, HIV changes its
genetics throughout the course of an infection in an individual,
creating mutant virions that react differently to prescribed
medicines, often gaining resistance to the drugs as the infection
lives its course in the body. Research suggests that antibody
responses to HIV will not be helpful in containing the disease's
spread inside an infected person, but neutralizing antibodies
could be an important part of a vaccine that works through
immunization. Traditional vaccine modalities may not provide the
same response in the body to HIV as they do with other diseases,
because of the complex biology of HIV, ruling out live attenuated
virus vaccines, inactivated virus vaccines, and recombinant
protein vaccines. Instead, researchers are investigating the use
of plasmid DNA immunogens, which elicit cell-mediated immune
responses, and live recombinant vectors, which use live
microorganisms to carry the genes needed for an immune response
through the body. Pox viruses represent a promising potential
HIV vaccine vector, providing infection and immunogenicity while
remaining highly attenuated in their pathogenicity. The studies
indicate that even if a vaccine cannot quickly be developed to
prevent infection, one may soon be available to slow its
progression significantly.
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