Status and Current Prospects for the Immunotherapy of Human Immunodeficiency Virus (HIV) Infection

Abstract

Infection with the HIV virus and its sequelae have received considerable attention in the last decade. Acquired Immune Deficiency Disease (AIDS) has come to dwarf cancer, not in magnitude of research and treatment, but certainly in the intensity of effort and volume of new findings concerning its pathogenesis and management. The very rapid development of the understanding of this disease now allows us to focus more clearly on the major issues involved. In magnitude, the problem is considerable with an estimated 1 to 1.5 million Americans infected and a world wide total of 6–8 million infected. With close to 200,000 AIDS cases in the United States, there are estimated over 600,000 cases worldwide. By current calculations, all are expected to die of the disease. Two important features mollify these expectations. First, the growth of the disease is slowing as a result of progressive saturation of high risk groups and the reduced frequency of spread through the use of “safe sex”. The degree of spill over into the remainder of the population is relatively small. The largest open door yet to be closed remains indiscriminate heterosexual contact, particularly in the presence of concomitant venereal disease. While little can be done to prevent the spread amongst the illiterate, uninformed, or unwilling, the progress of prevention among the cooperative is encouraging. Second, the latency period of the virus in those who reduce their exposure to other immunosuppressive influences (e.g., co-passenger viruses like CMV, EBV, herpes viruses, hepatitis viruses, etc., and recreational drugs, intrarectal sperm, poor nutrition, etc.) can now exceed 10 years. Thus, a longer, healthier life can be envisioned for those who will cooperate with a healthy regimen.