The future of mucosal HIV vaccines

Approximately 33 million people live with the human immunodeficiency virus (HIV) and 2.6 million new infections are acquired each yea1. The development of an effective HIV vaccine that induces robust mucosal immunity represents a major global public health challenge. Large human efficacy trials of simple antibody-based and cytotoxic T cell-based vaccines have failed to provide any protection. The recent RV144 HIV vaccine efficacy trial in Thailand using a prime-boost combination of vaccines, however, showed modest efficacy (31%, p=0.04 on the primary analysis). Although the efficacy was marginal, the study has provided considerable hope that a vaccine to prevent infection by HIV may be feasible.