Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
J Acquir Immune Defic Syndr. 2012 Aug 1;60 Suppl 2(0 2):S41-3. doi: 10.1097/QAI.0b013e31825b7118.
Although many new prevention modalities that include the use of antiretroviral drugs show promise, there is no question that a global solution to the HIV epidemic will not be economically or logistically feasible without the development of vaccine that provides durable protection. In the best case scenario, the vaccine has to protect against acquisition of infection, likely mediated by Env-specific B-cell responses combined with CD4+ T-cell responses to evoke full maturation and maintenance of protective antibodies. But HIV-specific CD8+ T-cell responses are also likely to be a key element, particularly for those inevitable situations in which full vaccine-induced protection from acquisition is not achieved, in which case durable control of established infection will be required. Although there is reason to be optimistic that an effective HIV vaccine is possible, one of the major constraints moving forward will likely be constraint on funding to support a diversity of concepts at a time that the correlates of protection from acquisition and disease progression are still unknown. Given the scope of the epidemic and the economic climate, we must strive to do much more with less and seek to access additional resources, both scientific and monetary, from every possible source.
虽然许多新的预防方法，包括使用抗逆转录病毒药物，显示出前景，但如果没有开发出能够提供持久保护的疫苗，那么全球范围内解决艾滋病流行问题在经济上和物流上都是不可行的。在最好的情况下，疫苗必须能够预防感染的获得，这可能需要通过 Env 特异性 B 细胞反应与 CD4+ T 细胞反应相结合来实现，以引起保护性抗体的完全成熟和维持。但 HIV 特异性 CD8+ T 细胞反应也可能是一个关键因素，特别是在那些无法完全通过疫苗获得预防感染的情况下，在这种情况下，需要持久控制已建立的感染。尽管有理由乐观地认为，一种有效的 HIV 疫苗是可能的，但向前推进的主要限制之一可能是资金限制，无法同时支持多种概念，而获得保护和疾病进展的相关性仍然未知。考虑到疫情的范围和经济形势，我们必须努力用更少的资源做更多的事情，并寻求从各种可能的来源获得额外的科学和货币资源。
