Prospects for AIDS vaccines

AIDS Vaccine Researchedited by Flossie Wong-Staal and Robert C. Gallo, Marcel Dekker, 2002. US$165.00 hbk (342 pages) ISBN 0-8247-0645-5The AIDS pandemic is massive world problem, particularly in Africa and in some areas in Asia. An effective vaccine would appear to be the most pragmatic way of controlling it and solving the associated social and economic problems. Despite intense efforts, prospects for a vaccine that induces sterile immunity against HIV-1 infection remain bleak. However, promising results from vaccine candidates that induce cellular immunity against the virus have raised hopes of a vaccine that can at least contain HIV-1 replication and, as a result, prevents the disease from progressing.AIDS Vaccine Research, edited by Flossie Wong-Staal and Robert Gallo, has been published at a crucial juncture when AIDS vaccine development has taken an aggressive turn to carry out clinical trials for many vaccine candidates and strategies. The book comprises 12 review articles by authors who are leaders in the field of AIDS research. A broad range of AIDS vaccine research topics are covered and, although repetition of some information is unavoidable in a book composed of multiple review articles, overlapping is minimal, owing to a careful selection of topics by the editors. The information imparted is approximately two years old and, hence, recent progress is missing. However, the content of the book has been so carefully collected and organized that it does not miss much of the ebb and flow of current AIDS vaccine research.The book begins with an overview article, and then moves on to present three reviews that summarize our current knowledge of host–virus interaction, including immunopathogenesis of HIV-1 infection, HIV-1 genetic diversity and the role of cellular immune responses in HIV-1 infection. These articles build a solid platform for the subsequent discussions of specific vaccine strategies, including engineered vaccines, DNA vaccines, pseudo-type vectors and mucosal vaccines. The theoretical foundation and the potential use of these vaccine strategies are well-described. The book ends strongly with a review of the role of non-human primates in AIDS vaccine development and a discussion of international perspectives on vaccine development.However, despite the positive aspects of many individual chapters, this volume falls short of being a comprehensive review of AIDS vaccine development. For example, it is missing reviews of envelope-glycoprotein strategies and poxvirus-based HIV vaccines (other than briefly mentioning boosting by ‘modified vaccinia virus Ankara’ in the chapters on cytotoxic-T-lymphocyte vaccines and DNA vaccines). This book also lacks any discussion of novel vector systems, such as vesicular stomatitis virus, Venezuelan equine-encephalitis virus, polio and adeno-associated virus. Perhaps the most surprising omission is any discussion of adenoviral-vector-based HIV vaccine strategies, which are currently moving into expanded phase-II trials in humans, following promising results in simian–human-immunodeficiency-virus-challenge studies and phase-I human trials. It would have been useful for the average reader had this book provided more balanced information regarding the human vaccine trials that have already been performed, as well as those that are still in progress. It is somewhat misleading to devote entire chapters to retroviral-vector strategies and salmonella-based vaccines while omitting any discussion of some of the leading vaccine strategies that are further ahead in clinical development.Overall, the book provides strong background information relevant to HIV vaccine development and some outstanding reviews on individual topics, but fails to provide a balanced and comprehensive view of current HIV vaccine research efforts.