The Maginot Line and AIDS vaccines

Despite extensive and costly efforts, attempts to develop a vaccine against human immunodeficiency virus (HIV), the causative agent of the acquired immunodeficiency syndrome (AIDS), have been unsuccessful. Using the Maginot Line as a metaphor, we discuss the reasons why an antibody-based vaccine strategy against HIV has failed. The concept of a vaccine that exclusively promotes cell-mediated immunity against the virus is outlined, and important factors in the formulation of this novel vaccine are delineated. In particular, vaccine adjuvants and HIV peptides that elicit a cell-mediated immune response are crucial components of this immunization strategy. Examination of primate immune systems that resist retroviral pathogenicity will also play an important role in the development of a successful AIDS vaccine.