Abstract
The development of an effective HIV-1 vaccine continues to pose a formidable challenge. While traditional approaches of live-attenuated and inactivated vaccines are either too dangerous or inefficient, modern and safer subunit vaccines are still in their infancy and struggle to cope with various aspects of HIV-1 biology, including the enormous variability of HIV-1. Three simple prophylactic candidate vaccine strategies have now been tested in human efficacy trials, with only a very marginal and yet to be confirmed success in the most recent one. Thus, HIV-1 immunological control, which may require induction of both broadly neutralizing antibodies and T cells capable of controlling multiple clades and escape variants. At protective levels, an increase in subunit vaccine design complexity is required. I argue that, by analogy to antiretroviral treatment, even a relatively complex vaccine may not only serve to prove the concept, but can be successfully deployed in countries with limited resources and infrastructure.
Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.