"cART intensification by the HIV-1 Tat B clade vaccine

progress to phase III efficacy studies"

Aurelio Cafaro, Cecilia Sgadari, Orietta Picconi, Antonella Tripiciano, Sonia Moretti, Vittorio Francavilla, Maria Rosaria Pavone Cossut, Stefano Buttò, Giovanni Cozzone, Fabrizio Ensoli, Paolo Monini, Barbara Ensoli

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: In spite of its success at suppressing HIV replication, combination antiretroviral therapy (cART) only partially reduces immune dysregulation and loss of immune functions. These cART-unmet needs appear to be due to persistent virus replication and cell-to-cell transmission in reservoirs, and are causes of increased patients' morbidity and mortality. Up to now, therapeutic interventions aimed at cART-intensification by attacking the virus reservoir have failed. Areas covered: We briefly review the rationale and clinical development of Tat therapeutic vaccine in cART-treated subjects in Italy and South Africa (SA). Vaccination with clade-B Tat induced cross-clade neutralizing antibodies, immune restoration, including CD4+ T cell increase particularly in low immunological responders, and reduction of proviral DNA. Phase III efficacy trials in SA are planned both in adult and pediatric populations. Expert commentary: We propose the Tat therapeutic vaccine as a pathogenesis-driven intervention that effectively intensifies cART and may lead to a functional cure and provide new perspectives for prevention and virus eradication strategies.

Original languageEnglish
Pages (from-to)115-126
Number of pages12
JournalExpert Review of Vaccines
Volume17
Issue number2
DOIs
Publication statusPublished - Feb 2018

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HIV-1
Vaccines
Therapeutics
South Africa
Viruses
Combined Vaccines
Virus Replication
Neutralizing Antibodies
Italy
Vaccination
HIV
Pediatrics
Morbidity
T-Lymphocytes
Mortality
DNA
Population

Cite this

Cafaro, A., Sgadari, C., Picconi, O., Tripiciano, A., Moretti, S., Francavilla, V., ... Ensoli, B. (2018). "cART intensification by the HIV-1 Tat B clade vaccine: progress to phase III efficacy studies". Expert Review of Vaccines, 17(2), 115-126. https://doi.org/10.1080/14760584.2018.1418666

"cART intensification by the HIV-1 Tat B clade vaccine : progress to phase III efficacy studies". / Cafaro, Aurelio; Sgadari, Cecilia; Picconi, Orietta; Tripiciano, Antonella; Moretti, Sonia; Francavilla, Vittorio; Pavone Cossut, Maria Rosaria; Buttò, Stefano; Cozzone, Giovanni; Ensoli, Fabrizio; Monini, Paolo; Ensoli, Barbara.

In: Expert Review of Vaccines, Vol. 17, No. 2, 02.2018, p. 115-126.

Research output: Contribution to journalArticle

Cafaro, A, Sgadari, C, Picconi, O, Tripiciano, A, Moretti, S, Francavilla, V, Pavone Cossut, MR, Buttò, S, Cozzone, G, Ensoli, F, Monini, P & Ensoli, B 2018, '"cART intensification by the HIV-1 Tat B clade vaccine: progress to phase III efficacy studies"', Expert Review of Vaccines, vol. 17, no. 2, pp. 115-126. https://doi.org/10.1080/14760584.2018.1418666
Cafaro, Aurelio ; Sgadari, Cecilia ; Picconi, Orietta ; Tripiciano, Antonella ; Moretti, Sonia ; Francavilla, Vittorio ; Pavone Cossut, Maria Rosaria ; Buttò, Stefano ; Cozzone, Giovanni ; Ensoli, Fabrizio ; Monini, Paolo ; Ensoli, Barbara. / "cART intensification by the HIV-1 Tat B clade vaccine : progress to phase III efficacy studies". In: Expert Review of Vaccines. 2018 ; Vol. 17, No. 2. pp. 115-126.
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AB - INTRODUCTION: In spite of its success at suppressing HIV replication, combination antiretroviral therapy (cART) only partially reduces immune dysregulation and loss of immune functions. These cART-unmet needs appear to be due to persistent virus replication and cell-to-cell transmission in reservoirs, and are causes of increased patients' morbidity and mortality. Up to now, therapeutic interventions aimed at cART-intensification by attacking the virus reservoir have failed. Areas covered: We briefly review the rationale and clinical development of Tat therapeutic vaccine in cART-treated subjects in Italy and South Africa (SA). Vaccination with clade-B Tat induced cross-clade neutralizing antibodies, immune restoration, including CD4+ T cell increase particularly in low immunological responders, and reduction of proviral DNA. Phase III efficacy trials in SA are planned both in adult and pediatric populations. Expert commentary: We propose the Tat therapeutic vaccine as a pathogenesis-driven intervention that effectively intensifies cART and may lead to a functional cure and provide new perspectives for prevention and virus eradication strategies.

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