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| Therapeutic Vaccinations |
| Presentation Time: Sunday, 3:30 p.m. - 4:00 p.m. |
MICHAEL LEDERMAN;
Case Western Reserve Univ. Center for AIDS Research, University Hospitals, Cleveland, OH. |
| Presentation Number: 424 |
| The demonstration that vaccination could prevent clinical variola provided a dramatic demonstration of the concept of "immunity" and also began a new era in the control of infectious disease. Since then, numerous epidemic and pandemic infectious diseases have been prevented or eradicated as a result of broad or targeted application of immunization strategies. Immune defenses can not only be harnessed to prevent infection but increasingly are also recognized as key determinants of the outcome of infectious diseases. This has raised the tantalizing possibility that immunization may also be utilized as a strategy to affect the course of established infection. To date, however, there is little precedent that immunization after infection is established can alter its natural history. On the one hand, it is not clear that additional exposure to small quantities of vaccine antigens in the setting of chronic infection and high level antigen expression will enhance already-established immune responses. On the other hand, targeted delivery of vaccine antigens to "better" sites by "better" antigen presenting cells may optimize and broaden pre-existing immune responses. HIV-1 infection may be an ideal setting in which to test the feasibility of therapeutic immunization as high level HIV-1 replication directly targets and impairs host defenses. Thus exposure to viral antigen during lower levels of HIV-1 replication as is the aim of some treatment interruption strategies or via immunization after HIV-1 replication is controlled pharmacologically are reasonable strategies to test the feasibility of therapeutic immunization in established infectious diseases. |
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