Targeting early infection to prevent HIV-1 mucosal transmission

HIV: transmission failure The goal of preventing sexual mucosal transmission of HIV/AIDS, the principal route of acquisition, remains a priority if the pandemic is to be contained and HIV ultimately eradicated. In a review focused on pathogenesis in tissues relevant to mucosal transmission, particularly in the well characterized simian immunodeficiency virus rhesus macaque model, Ashley Haase argues that prevention strategies should target the earliest stage of infection — using both vaccines and microbicides. Measures to prevent sexual mucosal transmission of human immunodeficiency virus (HIV)-1 are urgently needed to curb the growth of the acquired immunodeficiency syndrome (AIDS) pandemic and ultimately bring it to an end. Studies in animal models and acute HIV-1 infection reviewed here reveal potential viral vulnerabilities at the mucosal portal of entry in the earliest stages of infection that might be most effectively targeted by vaccines and microbicides, thereby preventing acquisition and averting systemic infection, CD4 T-cell depletion and pathologies that otherwise rapidly ensue.