The virus also quickly mutates while multiplying in the body.
Development of new vaccines
This requires a robust vaccine that can initiate antibody production against a wide range of HIV strains. HIV-1 and HIV-2 have many differences, including several different subtypes, 4 which makes vaccine development challenging. In addition, there is a high mutation rate of HIV reverse transcriptase, the enzyme used to transcribe the viral genome during replication.
Technical difficulties in trial design, such as mucosal sample collection and processing, must be addressed in order to achieve the best evaluation of novel vaccines. Many studies have focused on developing a vaccine against HIV-1; these vaccines also need to be tested for prevention of HIV-2 infection. Some patients develop simultaneous HIV-1 and HIV-2 infections, so research is focusing on understanding the mechanism of this comorbidity. Since HIV-2—infected patients are located mainly in Africa, an efficacious yet cost-effective, affordable, and safe vaccine is the key to controlling the disease.
The stigma surrounding HIV disease must be addressed to encourage robust participation in trials. HIV infection is a major public-health concern.
Development of new vaccines
A safe and cost-effective vaccine that prevents HIV infection is considered the best strategy for containing the epidemic. Despite all the challenges of vaccine development, the RV trial proved that an HIV vaccine can be a reality. Additional studies are needed to develop a vaccine with optimal safety and efficacy to positively affect HIV disease prevention and control, as well as patient health and survival.
World Health Organization. Accessed August 24, Crystal structure of human immunodeficiency virus HIV type 2 protease in complex with a reduced amide inhibitor and comparison with HIV-1 protease structures. HIV-2 and T cell recognition. Curr Opin Immunol. Cold Spring Harb Perspect Med.
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HIV Surveillance Report, Published February Accessed September 10, Accessed August 19, Persistent CCR5 utilization and enhanced macrophage tropism by primary blood human immunodeficiency virus type 1 isolates from advanced stages of disease and comparison to tissue-derived isolates. J Virol.
The gastrointestinal tract is critical to the pathogenesis of acute HIV-1 infection. J Allergy Clin Immunol. Association between virus-specific cytotoxic T-lymphocyte and helper responses in human immunodeficiency virus type 1 infection. Adv Immunol. J Exp Med.
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Immunopathogenesis and immunotherapy in AIDS virus infections. Nat Med.
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- Preventive HIV Vaccines: Progress and Challenges.
Vaccine-elicited antibodies mediate antibody-dependent cellular cytotoxicity correlated with significantly reduced acute viremia in rhesus macaques challenged with SIVmac J Immunol. Antibody from patients with acute human immunodeficiency virus HIV infection inhibits primary strains of HIV type 1 in the presence of natural-killer effector cells. Rapid evolution of the neutralizing antibody response to HIV type 1 infection.
Guidelines for the use of antiretroviral agents in HIVinfected adults and adolescents. Fletcher C.
Human immunodeficiency virus infection. Pharmacotherapy: A Pathophysiologic Approach. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection.
N Engl J Med. Types of vaccines. Broadly neutralizing antibodies against HIV templates for a vaccine. HIV vaccine: hopes and hurdles.
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