Modulation of HIV-1 immunity by adjuvants

Moody, M. Anthony

Vaccine candidates deemed the most promising advanced to phase I and phase II human trials. These studies tested proteins, peptides, and recombinant poxvirus vectors [31] , and although none of the candidates produced overwhelming immunity, the vaccines were generally safe and well tolerated. Without a stronger candidate available, a controversial decision was made to pursue a phase III trial of poxvirus prime-gp120 boost vaccine strategy. The proposal had detractors [32] and supporters [33] , and ultimately demonstrated a modest and shortlived degree of efficacy [34, 35] . The adjuvant used in that trial was alum, the only US Food and Drug Administration (FDA)-approved adjuvant at that time. Studies are now being considered to examine the same immunization regimen using more potent adjuvants to see whether protection can be enhanced or prolonged. The remainder of this review will address more recent developments in adjuvant research.