Abstract
The concept of using a vaccine to induce or enhance HIV-specific immune responses in those with established HIV infection has been through alternating waves of enthusiasm and skepticism over the past three decades of the HIV epidemic. The earliest therapeutic vaccination trials were conducted in subjects with uncontrolled viremia or suboptimal therapy and the highly activated and dysfunctional immune environment of such individuals would significantly impede the efficacy of any immunostimulatory approaches. Contemporary antiretroviral treatment assures potent and sustained inhibition of HIV replication, reduces immune activation and restores a variety of specific immune functions. This provides the context for a renewed level of scientific interest in the possibility of inducing HIV-specific immunity that could clear virally infected cells, retain long lived memory, and help reduce latent reservoirs of HIV that cannot be eliminated by current drugs or intensification strategies.
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