Therapeutic vaccines and immunotherapy revisited.

Imunotherapy to induce long-term, non-progressor status in HIV-1-positive persons may be considered in the context of highly active antiretroviral therapy (HAART). The aim of such therapy must be to allow the induction or regeneration of HIV-1-specific immune responses which have the potential to control viraemia, and to alleviate the immunosuppression caused by HIV-1. Trials of therapeutic vaccines and/or cytokines and/or hormones have been conducted and are briefly described. In many cases, potentially beneficial transient HIV-1-specific responses which may translate into clinical advantage have been induced, but these do not persist. Future studies are warranted so that: 1) novel immunogens and other immunotherapeutic agents are further defined and optimised; 2) therapeutic regimens are carefully and rationally designed; and 3) patients are followed for protracted periods of time to observe clinical benefit.