[Minutes, Advisory Committee to the Director GP-160 Meeting (1992: Bethesda, Maryland)]

21

1 slide depicts a long asymptomatic period, beginning
2 initially with only modest immunosuppression, later in
3 mid-course of disease a progressive immune decline,
4 and then when we hit the blue area, the symptomatic
5 state, a variety of opportunistic infections secondary
6 to immunosuppression.
7 Therefore, most of AIDS is clinically
8 silent. Most of HIV infection is clinically silent.
9 We only see clinical events in the latter part of the
10 disease. This will be relevant to our deliberations
11 regarding the methodologic approach, recalling that
12 the major attraction of vaccination is in the earlier
13 stages of disease when the immune system is most
14 competent, although we must test the approach in all
15 stages. Next slide, please.
16 Now briefly restating the rationale of
17 therapeutic vaccination, it's that immune boosting
18 with vaccination could or may slow the progression of
19 HIV through the induction of novel -- That's an
20 immunologic term, essentially. That is new cellular
21 and humoral immune responses to the vaccine.
22 If this is effective -- and that's an
NEAL R. GROSS
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