An African perspective on mucosal immunity and HIV-1

Mucosal Immunol. 2009 Jul;2(4):300-14. doi: 10.1038/mi.2009.23. Epub 2009 May 6.

Abstract

HIV prevention mandates an understanding of the mechanisms of mucosal immunity with attention to some unique features of the epidemic and mucosal environment in the developing world. An effective vaccine will have to induce mucosal protection against a highly diverse virus, which is equipped with a number of immune evasion strategies. Its development will require assessment of mucosal immune responses, and it will have to protect a mucosal environment where inflammation and altered immune responses are common because of the presence of other mucosal infections, such as sexually transmitted infections and parasites, and where nutritional status may also be compromised. Ideally, not only prevention methods would protect adults but also provide cover against gastrointestinal transmission through maternal milk. Prevention might also be complemented by microbicides and circumcision, two alternative approaches to mucosal protection. It seems unlikely that a single solution will work in all instances and intervention might have to act at multiple levels and be tailored to local circumstances. We review here some of the mucosal events associated with HIV infection that are most relevant in an African setting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS Vaccines / immunology
  • AIDS Vaccines / therapeutic use*
  • Africa
  • Anti-Infective Agents / administration & dosage
  • Circumcision, Male
  • Developing Countries*
  • Female
  • HIV Infections / immunology*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • HIV-1*
  • Humans
  • Immunity, Innate
  • Immunity, Mucosal*
  • Male
  • Sexually Transmitted Diseases / immunology
  • Sexually Transmitted Diseases / microbiology
  • Sexually Transmitted Diseases / prevention & control
  • Sexually Transmitted Diseases / virology
  • Vaccination

Substances

  • AIDS Vaccines
  • Anti-Infective Agents