Prospects for an effective T cell-based immunoprophylaxis against mother-to-child transmission of HIV-1.

Globally, more than 2000 children under 15 years of age are infected with HIV-1 every day. Some of these infections occur in utero, but the majority of children become infected at delivery and after birth through breast-feeding. While success of antiretroviral therapy dramatically decreased mother-to-child transmission in developed countries, antiretroviral drugs are not yet widely available and bottle-feeding is not an option in economically impoverished countries, where burden of HIV-1 infections is the highest. There, effective accessible HIV-1 vaccines limiting spread of HIV-1 in adults and preventing infection of neonates through breast-feeding are urgently needed. For infant vaccines, given the difficulties in inducing widely cross-reactive HIV-1-neutralizing antibodies, effort has now shifted towards elicitation of cell-mediated immunity, likely in a combination with passively infused neutralizing antibodies and/or chemoprophylaxis. This review discusses prospects of the T-cell approach for development of a paediatric HIV-1 vaccine.