Rational development of prophylactic HIV vaccines based on structural and regulatory proteins

The severity of the AIDS epidemic clearly emphasises the urgent need to exp edite HIV vaccine candidates into clinical trials. Prophylactic HIV vaccine candidates have been evaluated in non-human primates. Based on specific pr oof of principle studies the first phase III clinical studies have recently begun in humans. However, a truly effective HIV vaccine is not yet at hand and many problems related to specific properties of the virus remain to be overcome. Previously proven empirical approaches have largely failed and n ow rational thinking based on an understanding of immunity to lentiviral in fections is needed. This review addresses the scientific problems and compl ications facing the development of an HIV vaccine as well as the possible s trategies currently available to overcome these problems. Recent attention has focussed on identifying the immune correlates and mechanisms of protect ion from either HIV infection or protection from disease progression. Based on these observations, the logic and rational behind the development of mu ltiple component vaccine strategies are highlighted. (C) 2001 Elsevier Scie nce Ltd. All rights reserved.