Searching For Achilles’ Heel
Why is it so hard to make an HIV vaccine? The answer lies in the unusual relationship of this particular virus with its host.
By and large, viruses of humans and other animals interact with their hosts in one of two ways. After an initial period of rapid (often symptomatic) infection, some viruses (e.g., influenza) are cleared completely by the immune system. Others (e.g., many herpes viruses) establish a lifelong latent infection, only to reappear much later when conditions allow. In either case, the immune system effectively clears the virus from the host. Once established, the adaptive humoral response can prevent future infection with antigenically similar viruses. This is what makes vaccines work.

Achilles Wounded in the Heel
by Paris. Sculpture by Charles
Alphonse Gumery, 1850. Gumery
shows Achilles as nonchalantly
inspecting his wound, even
though it will eventually kill him.
Source.
Relatively recently, we learned that some retroviruses, including HIV and its dozens of primate lentivirus relatives, have evolved to infect hosts other than their original ones. In the original hosts, the primary infection is usually fairly mild, but the virus is only partially cleared by the immune system. Later, virus replication and cell killing continue at the same pace for the life of the host, although at a lower level. Usually, this process has little or no effect on the host’s lifespan, allowing the opportunity for transmission to naïve animals. When the virus jumps to a new host (such as the recent transfer of HIV-1 from chimpanzees to humans and of SIVmac from monkeys called sooty mangabeys to rhesus macaques), the process of infection is essentially the same, but eventually something goes awry. Infection leads to the slow, progressive loss of the target CD4+ (helper) T cells, and thence the nearly inevitable immune collapse and death of the host.
Clearly, the benign relationship of primate retroviruses with their primary hosts is the product of a very long period of coevolution. In the process, the virus has evolved two features to avoid the immune response and therefore to make an effective vaccine highly elusive to produce. Both arms of the immune response, humoral (antibodies) and cellular are so affected.










