Asian Journal of Immunology

HIV infection has remained a global health concern since its discovery over forty years ago. Although antiretroviral (ARV) drugs have changed the initial damning prognosis, the need to prevent new infection is still as pressing as ever because individuals who have achieved viral suppression on Antiretroviral therapy have an additional concern of increased susceptibility to non-AIDS-defining illnesses compared to the general population. This is attributable to the progressive immunological dysfunction in these individuals, a pathology that current therapeutic options for HIV management cannot ameliorate. Vaccination, which is the game-changing intervention for most communicable diseases, is constrained by the peculiar molecular bottleneck created by HIV hypermutability, making vaccine development quite challenging. This article reviews the dynamics of these challenges and makes a case for a customized vaccine development approach that leverages the insights gained from the HLA profiles of the HIV elite controllers. It then suggests a conceptual framework for developing a population-based CTL epitope-based HIV-1 vaccine using the Nigerian population as a model.