The critical role of CD4(+) T-cell help in immunity to HIV

Vaccine-induced immunity to HIV/AIDS is a world wide health priority and a necessity in order to prevent or curb the transmission of this infection in the different human populations at risk. Failing to prevent infection, it would be desirable to generate sufficient immunity to control viremia in individuals which become infected, given that this would provide sufficient protection to prevent progression to AIDS. From several different pre-clinical settings data revealed that although CTL or neutralising antibodies were necessary immune responses for protection from infection, they were alone or together insufficient for providing solid protective immunity. What was invariably necessary was a strong specific CD4(+) T-cell response. Protective T-helper responses were not skewed towards an IFN-gamma (Th1) or IL-4 (Th2) type response, but were balanced and characterised by the presence of a strong Ag-specific IL-2 response.