HIV infection is characterized by high levels of virus replication at all stages of infection. Virus replication causes increased levels of CD4 cell destruction and turnover, and when unchecked, immunodeficiency, AIDS and death. This model of pathogenesis has prompted a dramatic change in the treatment paradigm which has evolved from late intervention in symptomatic individuals to a """"""""hit early, hit hard"""""""" strategy. Therapies, though highly effective in many, are costly, complex, and require meticulous compliance and even in the best of circumstances, are difficult to maintain over the long term. We have enrolled HIV-infected individuals in a variety of clinical trials investigating the antiviral activity and immunologic effect of intensive antiretroviral regimens. Our patients include those newly infected; presenting for treatment within 90 days of infection, as well as chronically infected individuals. The response to therapy has been generally favorable, with nearly all subjects experiencing prolonged suppression of active virus replication and near complete disappearance of cells harboring detectable HIV in peripheral blood and tissue. This clinical trial aims to select subjects from our ongoing clinical trials with minimal detectable HIV-1. We plan to boost HIV-1 specific immune responses through vaccination in subjects with minimal viremia. Subjects will be given a prime/boost vaccine regimen using a canary pox construct expressing multiple HIV antigens including env, gag, pol, and nef as a prime and a soluble env protein as a boost. The induction of HIV-specific responses will be measured.
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