Tuberculosis vaccines.

The increasing incidence of disease associated with HIV infection highlights the crucial role of the immune response in susceptibility to tuberculosis and has stimulated renewed efforts to develop improved vaccines. Vaccine targets include prevention of infection in naive individuals, prevention of re-activation in individuals harbouring latent infection, and prevention of relapse by immunotherapy in tuberculosis patients. Advances in mycobacterial molecular genetics have facilitated development of a range of live attenuated and subunit vaccine candidates that have been screened in experimental models of infection. Evaluation of the immunogenicity of selected candidate vaccines in clinical trials should be combined with a continuation of fundamental research on the immune response to mycobacterial infection and persistence.