Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, and Australian Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Melbourne, Melbourne, VIC, Australia; Melbourne Sexual Health Centre and Department of Infectious Diseases, Alfred Health, Central Clinical School, Monash University, Melbourne, VIC, Australia.
Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Lancet HIV. 2019 Jun;6(6):e406-e410. doi: 10.1016/S2352-3018(19)30134-1. Epub 2019 May 9.
Vaccine-induced prevention of HIV infection is widely viewed as requiring both humoral and cellular immunity. Although the evidence for such a multipronged approach is not strong, this strategy increases the possibility that at least one mechanism of immunity could work to diminish new infections. The concept of broad immunity to HIV is attractive to funding bodies that seek at least some success from expensive trials. However, trying simultaneously to achieve both robust cellular and humoral immunity against HIV might be difficult. Furthermore, a multipronged approach increases the difficulty of later dissecting the immune correlates of protection and thereby iteratively improving HIV vaccines. This Viewpoint briefly discusses different approaches to tackling the challenge of inducing protective immunity to HIV and speculates on how results will move the field forward. We posit that, given the uncertain nature of immunity to HIV at present, focusing on inducing, evaluating, and optimising discrete individual mechanisms of immunity to HIV could provide the most rapid pathway to an effective HIV vaccine.
疫苗诱导预防 HIV 感染被广泛认为既需要体液免疫，也需要细胞免疫。尽管这种多管齐下的方法的证据并不充分，但这种策略增加了至少有一种免疫机制可以减少新感染的可能性。对 HIV 广泛免疫的概念对寻求昂贵试验取得至少部分成功的资助机构具有吸引力。然而，同时试图实现针对 HIV 的强大细胞和体液免疫可能具有挑战性。此外，多管齐下的方法增加了后期剖析保护免疫相关性并因此迭代改进 HIV 疫苗的难度。本观点简要讨论了应对诱导针对 HIV 的保护性免疫的挑战的不同方法，并推测了这些结果将如何推动该领域的发展。我们假设，鉴于目前对 HIV 免疫的不确定性，专注于诱导、评估和优化针对 HIV 的离散免疫机制可能是提供有效 HIV 疫苗的最快途径。
