Medicine
Volume 37, Issue 7 , Pages 321-325, July 2009

The immune response to HIV

Andrew McMichael MB BChir PhD CNAA FRCP FRS is Director of the Weatherall Institute of Molecular Medicine in Oxford University and Honorary Director of the Medical Research Council Human Immunology Unit. He was knighted in 2008 for services to medical sciences. Competing interests: none declared

Lucy Dorrell BM DM MRCP is Senior Clinical Lecturer at Oxford University and Honorary Consultant in Genitourinary Medicine, Oxford, UK. Competing interests: none declared

Abstract 

HIV-1 elicits vigorous humoral and cell-mediated responses: these fail to clear the infection but contain viral replication for several years, at the expense of ongoing immune activation and CD4+ T cell loss. Over the past 25 years, several mechanisms by which HIV-1 and other AIDS viruses evade host immune responses have been elucidated. Genetic variability, rapid establishment of a reservoir of latently-infected long-lived CD4+ T cells and resistance to neutralization by antibodies are formidable obstacles to the development of a preventive vaccine. This has been highlighted by the disappointing results of recent efficacy trials. However, this remains an urgent priority, as available prevention strategies have been insufficient to stop the global epidemic. Rare individuals who show no signs of progression after one or two decades of infection indicate that immune control of HIV-1 is possible and may inform vaccine design.

Keywords: antibody, HIV-1, HLA, SIV, T cell, vaccine

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PII: S1357-3039(09)00098-X

doi:10.1016/j.mpmed.2009.03.008

Medicine
Volume 37, Issue 7 , Pages 321-325, July 2009