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Abstract
Human immunodeficiency virus (HIV) sets several challenges for the development of a preventative HIV vaccine. Predictable, protective natural immunity against HIV does not occur and so unlike most other diseases for which vaccines exist, there are few guideposts from natural infection. Nonetheless, six vaccine efficacy trials have occurred. One in particular, the Thai trial called RV144, showed partial protective efficacy and potential ways ahead to a better vaccine approach. This coupled with other lessons from studies of acute infections as well as an increasingly complex knowledge of HIV-related vaccine immunology bring hope that a vaccine solution might be reached for this pervasive and deadly pandemic.
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Affiliation(s)
- D M Brett-Major
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA
| | - T A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA
| | - N L Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA
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Brett-Major DM, Scott PT, Crowell TA, Polyak CS, Modjarrad K, Robb ML, Blazes DL. Are you PEPped and PrEPped for travel? Risk mitigation of HIV infection for travelers. Trop Dis Travel Med Vaccines 2016; 2:25. [PMID: 28883969 PMCID: PMC5530928 DOI: 10.1186/s40794-016-0042-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/15/2016] [Indexed: 12/17/2022]
Abstract
The HIV pandemic persists globally and travelers are at risk for infection by the Human Immunodeficiency Virus (HIV). While HIV-focused guidelines delineate risk stratification and mitigation strategies for people in their home communities, travel issues are not addressed. In this review, direct and indirect evidence on HIV risk among travelers is explored. The burgeoning practice of employing pre-exposure prophylaxis (PrEP) with anti-retroviral therapy in the non-travel setting is introduced, as well as the more established use of post-exposure prophylaxis (PEP). Challenges in applying these lessons to travelers are discussed, and a new guidelines process is scoped and recommended.
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Affiliation(s)
- D M Brett-Major
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA.,Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA.,Division of Tropical Public Health, Department of Preventive Medicine and Biostatistics, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD USA
| | - P T Scott
- Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA
| | - T A Crowell
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA.,Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA
| | - C S Polyak
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA.,Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA
| | - K Modjarrad
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA.,Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA
| | - M L Robb
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD USA.,Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD USA
| | - D L Blazes
- Division of Tropical Public Health, Department of Preventive Medicine and Biostatistics, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD USA.,Bill and Melinda Gates Foundation, Seattle, WA USA
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Affiliation(s)
- D M Brett-Major
- DM Brett-Major, Infectious Diseases Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA. Email
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