The development of an AIDS vaccine: progress and promise.

The development of a safe and effective vaccine against infection by the human immunodeficiency virus (HIV) is of paramount importance to the prevention of AIDS worldwide. Although a great deal has been learned about HIV in a few short years, the development of an AIDS vaccine has proved to be extremely difficult. The lack of an appropriate animal model for AIDS, the absence of a defined protective immune response in persons infected with HIV, the long latent period between initial infection and the development of symptoms, the existence of multiple strains of HIV, and the spread of HIV by way of cell-associated virus are issues that complicate the development of an effective AIDS vaccine. Researchers are employing a multifaceted approach to the creation of a potential AIDS vaccine. These approaches include the use of killed or attenuated virus, purified natural or synthetic subunits of the virus, infectious recombinant viruses, and anti-idiotypes. The first clinical trial of a subunit AIDS vaccine began in September 1987 at the National Institutes of Health (NIH). Through support of basic research on AIDS vaccine development and the establishment of a mechanism for clinical trials of candidate vaccines, NIH is pursuing multiple approaches toward the goal of a vaccine against AIDS.