Una vacuna preventiva frente al VIH. Situación actual y perspectivas

Autores/as

  • José Alcamí Pertejo Instituto de Salud Carlos III

DOI:

https://doi.org/10.37536/RIECS.2020.5.2.235

Palabras clave:

VIH, Vacunas, Prevención

Resumen

En este artículo se analizan las distintas etapas y estrategias seguidas para conseguir una vacuna, y se intenta explicar los motivos por los que todos los prototipos ensayados han fracasado, el nuevo paradigma en el que se está trabajando y cuáles son los nuevos abordajes planteados en el momento actual.  Probablemente el motivo del fracaso es haber utilizado modelos clásicos y simplistas frente a un virus complejo que tiene unos mecanismos de escape diferentes a los de cualquier otro virus.

Citas

The changing face of HIV vaccine research. Kwong PD, Mascola JR, Nabel GJ. J Int AIDS Soc. 2012;15: 17407.

Protective effects of a live attenuated SIV vaccine with a deletion in the nef gene. Daniel MD, Kirchhoff F, Czajak SC, Sehgal PK, Desrosiers RC. Science. 1992;258:1938-41.

Pathogenic conversion of live attenuated simian immunodeficiency virus vaccines is associated with expression of truncated Nef. Sawai ET, Hamza MS, Ye M, Shaw KE, Luciw PA. J Virol. 2000;74:2038-45.

Pathogenicity of live, attenuated SIV after mucosal infection of neonatal macaques. Baba TW, Jeong YS, Pennick D, Bronson R, Greene MF, Ruprecht RM. Science. 1995;267:1820-5.

Randomized, double-blind, placebo-controlled efficacy trial of a bivalent recombinant glycoprotein 120 HIV-1 vaccine among injection drug users in Bangkok, Thailand.Pitisuttithum P, Gilbert P, Gurwith M et al. Bangkok Vaccine Evaluation Group. J Infect Dis. 2006;194:1661-71.

Differential Gag-specific polyfunctional T cell maturation patterns in HIV-1 elite controllers. Ferrando-Martínez S, Casazza JP, Leal M, Machmach K, Muñoz-Fernández MÁ, Viciana P, Koup RA, Ruiz-Mateos E. J Virol. 2012;86:3667-74.

Elite control of HIV infection: implications for vaccine design. Baker BM, Block BL, Rothchild AC, Walker BD. Expert Opin Biol Ther. 2009;9:55-69

Viral escape from dominant simian immunodeficiency virus epitope-specific cytotoxic T lymphocytes in DNA-vaccinated rhesus monkeys. Barouch DH, Kunstman J, Glowczwskie J et al. J Virol. 2003 l;77:7367-75.

Replication-incompetent adenoviral vaccine vector elicits effective anti-immunodeficiency-virus immunity. Shiver JM, Fu T-M, Chen L et al. Nature 2002;415:331-5.

Control of a mucosal challenge and prevention of AIDS by a multiprotein DNA/MVA vaccine. Amara RR, Villinger F, Altman JD et al. , Science. 2001;292:69-74.

Efficacy assessment of a cell-mediated immunity HIV-1 vaccine (the Step Study): a double-blind, randomised, placebo-controlled, test-of-concept trial. Buchbinder SP, Mehrotra DV, Duerr A et al. Step Study Protocol Team. Lancet. 2008;372:1881-1893

HIV-1 vaccine-induced immunity in the test-of-concept Step Study: a case-cohort analysis. McElrath MJ, De Rosa SC, Moodie Z et al. Step Study Protocol Team. Lancet. 2008;372:1894-1905.

Efficacy trial of a DNA/rAd5 HIV-1 preventive vaccine. Hammer SM, Sobieszczyk ME, Janes H et al. HVTN 505 Study Team. N Engl J Med. 2013;369:2083-92.

Use of adenovirus type-5 vectored vaccines: a cautionary tale. Buchbinder SP, McElrath J, Dieffenbach C and Corey L. Lancet 2020;396:e68-e69.

Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S et al. MOPH-TAVEG Investigators. N Engl J Med. 2009;361:2209-20..

Immune-correlates analysis of an HIV-1 vaccine efficacy trial. Haynes BF, Gilbert PB, McElrath MJ et al.. N Engl J Med. 2012;366:1275-86.

Evaluation of a mosaic HIV-1 vaccine in a multicentre, randomised, double-blind, placebo-controlled, phase 1/2a clinical trial (APPROACH) and in rhesus monkeys (NHP 13-19). Barouch D, Tomaka FL Wegmann F et al. Lancet 2018;392:232-243.

GP120: target for neutralizing HIV-1 antibodies. Pantophlet R, Burton DR. Annu Rev Immunol. 2006;24:739-69.

HIV-1 neutralizing antibodies: understanding nature's pathways. Mascola JR and Haynes BF. Immunol Rev 2013;254:225-44.

Toward an antibody-based HIV-1 vaccine. Hoxie JA. Annu Rev Med. 2010;61:135-52. doi: 10.1146/annurev.med.60.042507.164323.

Broadly neutralizing antibodies and the search for an HIV-1 vaccine: the end of the beginning. Kwong PD, Mascola JR, Nabel GJ. Nat Rev Immunol. 2013 Sep;13(9):693-701. doi: 10.1038/nri3516.

Rational design of vaccines to elicit broadly neutralizing antibodies to HIV-1. Kwong PD, Mascola JR, Nabel GJ. Cold Spring Harb Perspect Med. 2011;1:a007278.

HIV-1 Vaccines Based on Antibody Identification, B Cell Ontogeny, and Epitope Structure. Kwong PD and MAscola JR. Immunity 201848:855-871.

Identification and characterization of transmitted and early founder virus envelopes in primary HIV-1 infection. Keele BF, Giorgi EE, Salazar-Gonzalez JF et al. Proc Natl Acad Sci U S A. 2008;105:7552-7.

Publicado

30-11-2020

Número

Sección

Artículos de Revisión