D the number of new infections has been falling. However, the

D the number of new infections has been falling. However, the overall level of new infections is still high, and with significant reduction in mortality, the number of people living with HIV infection worldwide has increased.1 In the majority of cases, HIV infection occurs through homo- or heterosexual routes; however, the transmission of HIV from infected mother to child and through blood transfusion is also on the rise. “Safe sex” has been proposed as one of the major approaches to prevent sexual transmission of HIV. The use of male condoms greatly reduces the chances of acquiring sexually transmitted infections (STIs), including HIV infection, and in addition provides protection against conception. However, the usage of condoms by males is very low, as its use is perceived to reduce sexual pleasure. Female condoms have been developed to overcome this problem. Due to objections from the male partners and higher cost, their use is many times lower than male condoms.2 Currently, highly active antiretroviral (HAART) drugs belonging to four general categories nucleoside/nucleotide viral reversetranscriptase (RT) inhibitors (NRTIs), nonnucleoside RT inhibitors (NNRTIs), protease inhibitors, and fusion (or entry) inhibitors are the mainstream drugs to prevent and cure HIV infection.3 Usage of HAART drugs as a treatment option for HIV infection has expanded during the past few years.4 Treatment with a HAART triple-drug cocktail of two nucleoside inhibitors and one protease inhibitor can reduce the blood virus load below the detectable level (,50 copies of viral RNA/mL of plasma) in HIV-infected patients.Glibenclamide 5 Pre-exposure prophylaxis (PrEP) using a combination of two drugs, namely emtricitabine and tenofovir (TFV) disoproxil fumarate (TDF), showed an estimated efficacy of 44 against HIV infection in men who had sex with men, which is quite encouraging.Deoxycholic acid sodium salt 6 Long-term usage of available antiretroviral drugs leads to the issue of drug resistance and severe side effects, such as diarrhea, nausea, lipodystrophy, hyperglycemia, liver toxicity, pancreatitis, and neuropathy.PMID:23439434 4,7,8 To prevent HIV infections, attempts are also being made to develop vaccines, which are at different stages of development and clinical trials. Several vaccines using a variety of vectors, such as canarypox, adenovirus serotype 5 (Ad5), adeno-associated virus, and modified vaccinia virus Ankara strain, incorporating varieties of HIV proteins, aiming to generate either neutralizing antibodies or HIV-1-specific CD8+ T cells, have been evaluated in humans without significant success.93 DNA vaccines against HIV have also been proposed, primarily as a prime-boost strategy, whereby priming is donewith DNA vaccine followed by a vector-based vaccine. An alternate prime-boost strategy also comprises priming with live vector-based vaccine followed by booster with recombinant protein subunit vaccine. The RV144 vaccine, a combination of two genetically engineered vaccines (a “prime” vaccine called ALVAC-HIV [CCP1521] with a boost of the AIDSVAX gp120 vaccine, an envelope-protein segment from HIV subtypes B and E), showed protective efficacy of 31.2 when tested on more than 16,000 human volunteers in Thailand.14 The recent discontinuation of HVTN505 clinical trials by the US National Institute of Allergy and Infectious Diseases is a setback to the area of vaccine development. This vaccine comprised of priming with DNA vaccine followed by booster with Ad5-expressing surface and structural prot.