Plotkin's Vaccines (Eighth Edition) - Chapter 31: Human Immunodeficiency Virus Vaccines

Elsevier, Plotkin's Vaccines (Eighth Edition), 2023, Pages 458-483.e15
Barton F. Haynes, Kevin Wiehe, Priyamvada Acharya, Kevin O. Saunders

HIV-1 vaccine development is a critical global health priority. The reasons why we do not have an HIV-1 vaccine as yet are many, including a dense envelop glycan shield, rare neutralizing B cell precursors, the need for improbable neutralizing antibody mutations, and disfavored protective antibodies by immune tolerance mechanisms. Current work is ongoing to design strategies to overcome these roadblocks in vaccine design include targeting the naive B cell receptors of rare broadly neutralizing antibody clonal lineages, and design of sequential immunogens to lead or guide protective antibody development. In addition, T cell immunogens are being designed to induce broad cytotoxic T cell responses to overcome HIV-1 diversity.