Table 1.

Factors contributing to the ineffective antibody response against HIV in infected individuals

Impediment	Consequence	Refs
High degree of HIV diversity	Challenge for vaccine-induced immunity	121
Poor immunological access to conserved HIV Env regions	Few broadly reactive neutralizing antibodies	121
Delay in neutralizing antibody response	Virus dissemination	115,116
Rapid viral mutation rate and selection pressure	Virus escape	115,116
Paucity of virus-specific IgAs at mucosal sites	Virus dissemination	117,118
Polyclonal activation	Few specific antibodies of low specificity; few memory B cells	1,22,23,63
Natural antibodies cross-react with self antigens	Tolerance	31
Functional exhaustion of B cells	Few specific antibodies of low specificity	52
Paucity of IgM+ memory B cells	Decreased natural immunity	92
Interference by Nef	Suppressed class switching	44

Env, envelope protein.