Advances in HIV vaccine development have been hampered by
roadblocks associated with failure to prevent infection. In recent years, a
number of basic and translational science advances have shown promise in the
development for an effective vaccine. In their review, Haynes and colleagues
summarize these advances along with the roadblocks that still remain, as well
as the most promising approaches to successful vaccine design (J Allergy Clin Immunol 2014, 134(1): 3-10).
This year, the field of HIV-vaccine research had a major
disappointment in the announcement of the lack of a vaccine efficacy seen in a
DNA prime, recombinant adenovirus type 5 (rAd5) boost HIV-1 vaccine trial
developed by the NIH Vaccine Research Center. The vaccine was designed to test
the hypothesis that high levels of CD8+ cytotoxic T cells (CTLs) could either
protect against transmission or lead to control of plasma HIV-1 viral load. The
second failed trial, the Merck recombinant adenovirus type 5 trail, not only
lacked vaccine efficacy, but also appeared to enhance infection in those
vaccines seropositive for Ad5. Although these 2 trials were of great
disappointment, they provided valuable information on the types of immune
responses that are unlikely to be protective.
New advances have demonstrated a variety of promising
results such as the discovery of new envelope (Env) targets of potentially
protective antibodies. A recent study shows promise with the finding that CD8+
T cells are associated with control and eradication of early retrovirus
infections in rhesus macaques. Another recent study shows that the development
of immunogens to overcome HIV-1 T cell epitope diversity while another study
identifies correlates of transmission risk in an HIV-1 efficacy trail. And
finally, a recent advancement has mapped the co-evolution of HIV-1 founder Env
mutants in infected individuals who develop broad neutralizing antibodies
(bnAbs), thereby defining bnAb developmental pathways.
Despite these advances, the field is still years away from
deployment of an effective vaccine. Moving forward in HIV-1 vaccine research
requires the conversion of subdominant immune responses into dominant ones,
which has yet to be accomplished by an infectious disease vaccine. HIV-1
vaccine research is breaking promising new ground in vaccinology, and success
in its development will herald success for other difficult vaccines such as
influenza and hepatitis C.