Prospects for HIV-1 therapeutic immunisation and vaccination: the potential contribution of peptide immunogens

Background: Human immunodeficiency virus (HIV)-1 infection continues to challenge the development of antigen-specific immune-based strategies for the management (therapeutic immunisation) and prevention (vaccination) of HIV-1 infection. Objective: This review aims to assess current prospects for HIV-1 therapeutic immunisation with particular emphasis on the contribution of peptide-based immunogens. Methods: The potential for therapeutic immunisation to provide immunological support that can allow for prolonged safe ART-free periods is discussed in light of the Strategies for Management of Antiretroviral Therapy (SMART) study. Different approaches to peptide design are considered including the quality of T-cell responses desired. Results/conclusion: Synthetic peptide immunogens are amenable to modification to improve immunogenicity and reactivity to multiple virus subtypes. Ideally peptide immunogens should incorporate combinations that target restricted, relevant polyfunctional epitopes to regions of HIV-1 associated with control of infection. Peptides showing a beneficial effect following therapeutic immunisation may provide the basis for a future preventative vaccine.