Page 2 Adam • Evaluation of the Humoral/Fc-mediated Immune Responses… successes of medications like Truvada©, is that PrEP treatments have a couple crucial flaws that could be remedied with a vaccine. First, and most importantly, a consistent lack of patient adherence to the strict dosage schedule of PrEP treatments remains a pertinent issue (whether this be due to simple forgetfulness of patients, poorly informed patients, or more cultural factors) leading to significantly decreased protection against infection (Pitisuttithum & Marovich, 2020). In fact, according to an NIH article, during a PrEP study called “iPrEX”, researchers discovered that Truvada©, when administered to 2,500 men who have sex with other men (MSM), only provided around a 44% reduction in infection risk when it was not taken as prescribed (daily), as opposed to around a 92% reduction in infection risk when taken daily (National Institutes of Health, 2020). Another critical problem with PrEP, is that it isn’t universally available to everyone, only being available to citizens of countries in which the PrEP medication is licensed. For example, Truvada© is only licensed in a handful of countries. Finally, PrEP, oddly enough, has demonstrated varying degrees of effectiveness in women - though it isn’t known if this is due to functional differences in PrEP stemming from physiological differences in men or women, or if this is due to differences in adherence between men and women (Pitisuttithum & Marovich, 2020). Therefore, it is evident that a preventative vaccine against HIV-1 is still a crucially needed goal in the fight against the HIV-1 pandemic, especially because an HIV-1 vaccine regimen would be far less burdensome upon the individual - likely only needing a priming shot and a few booster shots to provide protection rather than taking a medication daily (Barouch et al., 2018). HIV-1 Pathogenesis: From MALT Infection to AIDS Development Now having a general understanding of the need for a vaccine, it also important to acquire a broad understanding of what HIV-1 (Human immunodeficiency virus type 1) is, how it’s transmitted, the mechanism of its pathogenesis, the disease(s) it causes, and the immune system’s response to HIV-1. Understanding these topics will provide background on the disease a prophylactic HIV-1 vaccine would prevent, as well as providing helpful context regarding the environment and challenges in which a vaccine would have to successfully operate in. To begin with, HIV-1 is a retrovirus from the viral family, Retroviridae. Being a retrovirus, HIV-1’s genome is composed exclusively of RNA rather than DNA. Though there is no unanimous consensus regarding the exact origins of this virus in humans, it is known that HIV began as a virus that infected African primates and later mutated to begin infecting humans within the last 100 years. One favored explanation as to the zoonotic transmission of this virus to humans, suggests that HIV was passed to humans via the consumption of infected chimpanzee meat. It wasn’t until the 1980’s however, that the virus began spreading globally (Engelman & Cherepanov, 2012). Today, due to the genetic diversity of
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