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Therapeutic vaccination for HIV: hopes and challenges

Stephenson, Kathryn E.a,b,c

doi: 10.1097/COH.0000000000000491
PROGRESS IN ACHIEVING LONG-TERM HIV REMISSION: Edited by Jean-Daniel Lelièvre and Timothy J. Henrich
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Purpose of review This review summarizes the recent landscape of HIV therapeutic vaccine research, emphasizing the results of randomized controlled trials that included analytical treatment interruption (ATI) to assess efficacy.

Recent findings Therapeutic vaccines for HIV are designed to re-educate the host immune response in HIV-infected individuals to better control viral replication in the absence of antiretroviral therapy. No therapeutic vaccine has yet to induce long-term HIV remission following ATI in a randomized controlled trial. This is likely because the vaccines have not elicited a broad enough immune response to suppress the diverse escape variants that emerge during viral rebound, and have not been used with effective agents to reduce the HIV reservoir. Recent studies in nonhuman primates using combination approaches are showing significant successes, with several candidates eliciting significant antiviral activity following ATI. Future studies pairing these vaccines with effective reservoir reduction hold great promise.

Summary Therapeutic vaccines aim to modulate the immune system of HIV-infected individuals to elicit sustained virologic control in the absence of antiretroviral therapy. Therapeutic vaccines that elicit broad immune responses have recently shown promise in randomized controlled trials and nonhuman primate studies.

aCenter for Virology and Vaccine Research, Beth Israel Deaconess Medical Center

bHarvard Medical School, Boston

cRagon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA

Correspondence to Kathryn E. Stephenson, MD, MPH, Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, E/CLS – 1036, 330 Brookline Avenue, Boston, MA 02215, USA. Tel: +1 617 735 4556; e-mail: kstephen@bidmc.harvard.edu

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