Immunotherapy and therapeutic vaccines in HIV infection.
Resistance to medication, adverse effects in the medium-long term, and cost are important limitations to lifelong adherence to highly active antiretroviral therapy (HAART). The combination of HAART with immune therapy to restore and/or boost immune-specific responses to HIV has been proposed, with the ultimate aim of controlling viral replication in the absence of HAART over long periods. The functional defects of the cellular and humoral responses would explain the lack of control of the immune system over viral replication. Different types of immune-mediated therapy have been investigated to solve these problems, including passive immune therapy, cytokines, structured treatment interruptions, immunosuppressors and therapeutic vaccines. Our still limited knowledge of immune mechanisms which can control HIV viral replication and of the causes of the deterioration of cellular and humoral immunity have produced only modest benefits in immune-mediated therapy, and are therefore confined to research for the time being. The availability of an optimal therapeutic vaccine would be an important scientific advance which could be compared with the arrival of protease inhibitors in clinical practice. Therefore, priority should be given to research in this field.
García
Felipe
F
Servicio de Enfermedades Infecciosas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universidad de Barcelona, Spain. fgarcia@medicina.ub.es
Ruiz
Lidia
L
López-Bernaldo de Quirós
Juan Carlos
JC
Moreno
Santiago
S
Domingo
Pere
P
D016915:AIDS Vaccines / Q000627:therapeutic use*; D000818:Animals; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D016207:Cytokines / Q000627:therapeutic use; D004195:Disease Models, Animal; D004311:Double-Blind Method; D015658:HIV Infections / Q000188:drug therapy / Q000628:therapy*; D015497:HIV-1 / Q000276:immunology* / Q000502:physiology; D006801:Humans; D007116:Immunization, Passive; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy; D016233:Immunotherapy, Active; D016219:Immunotherapy, Adoptive; D008251:Macaca; D051379:Mice; D015337:Multicenter Studies as Topic; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology / Q000637:transplantation; D014779:Virus Replication / Q000276:immunology
D016915:AIDS Vaccines; D019380:Anti-HIV Agents; D016207:Cytokines; D007166:Immunosuppressive Agents