[Chemotherapy and vaccine against HIV infection]

Anti-HIV treatment is the major strategy against HIV infection and AIDS. Nucleoside reverse transcriptase inhibitors have been studied extensively, and some of them have been approved for clinical use. Efficacy of non-nucleoside reverse transcriptase inhibitors and HIV-protease inhibitors are also being confirmed. It became clear, however, that all of these agent, allow emergence of drug-resistant HIV mutants when used as monotherapy. Therefore, combination therapy or alternating therapy using these and other new agents may become the main mode of treatment in the future. Clinical trials for HIV vaccines are now being conducted in U.S.A. and other countries. In many of them, immunological responses were confirmed, although clinical benefit was not known yet. Vaccines which induce cellular immunity against broad spectrum of epitopes are desired to overcome viral mutations. Gene therapy is very attractive, and extensive studies are being conducted in many laboratories including ours. Methodology for early and correct diagnosis of opportunistic infections are now developing especially by using molecular technology. Steady improvement in the clinical management of opportunistic infections is achieved.