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July 15, 1992

Infectious Diseases

Author Affiliations

Cornell University Medical College, New York, NY; Merck & Co Inc, Rahway, NJ

JAMA. 1992;268(3):366-368. doi:10.1001/jama.1992.03490030078036

The effort to create an effective human immunodeficiency virus (HIV) vaccine has moved to the forefront of acquired immunodeficiency syndrome (AIDS) research. As recently as a few years ago, there was widespread pessimism as to the possibility of an HIV vaccine. The change has been propelled by reports from several laboratories that inactivated or recombinant simian immunodeficiency virus vaccines can induce protective immunity in monkeys. The finding of vaccine-induced immunity to simian immunodeficiency virus, a virus closely related to HIV, suggests that protective immunity against HIV is achievable.

Multiple strategies of inducing HIV immunity are being tested, including administration of inactivated virus, recombinant viral proteins, or recombinant live vaccines that express viral antigens. Use of recombinant live vectors, such as Calmette-Guerin bacillus, may be particularly useful in inducing cell-mediated immunity.1

Pilot studies on the safety and immunogenicity of HIV vaccines are encouraging. For example, phase I trials of a