The ideal vaccine would decrease transmission of the infection between partners and would prevent complications of disease.

Bacterial STDs are common infections and they cause important morbidity as well as potentiation of HIV transmission. The effort to develop vaccines to prevent these infections is challenging and is a very important goal.

SUMMARY

Bacterial infections of the genital tract (gonorrhea, chlamydia, chancroid, syphilis) are common and cause significant morbidity. Their importance is heightened by recent appreciation of their roles in facilitation of transmission of the human immunodeficiency virus (HIV). Each is capable of causing repeated infections, suggesting lack of permanent broadly effective immunity. An effective vaccine has yet to be developed for any of these diseases. Rapid progress in understanding the molecular basis for pathogenesis of infection, including mechanisms for escape from otherwise effective immune surveillance and mechanisms for causing injury to host cells, has stimulated renewed efforts to make vaccines for some of these infections. Progress has been greatest for Neisseria gonorrhoeae and Chlamydia trachomatis. Present emphasis is on the major or principal outer membrane proteins of N. gonorrhoeae and C. trachomatis, based on evidence for neutralizing antibodies directed against surface-exposed variable domains of each of these proteins. Other surface-exposed proteins, including the iron-repressible transferrin receptor in gonococci and certain heat-shock proteins in chlamydia, also may be targets for vaccines. Although much remains to be learned, cautious optimism is warranted.

REFERENCES

1. Danielsson, D. (1990) Scand. J. Infect. Dis. Suppl. 69, 69–76.

2. Torvald, R. (1990) Scand. J. Infect. Dis. Suppl. 69, 157–167.

3. Division of STD/HIV Prevention, U.S. Department of Health and Human Services, Public Health Service (1992) Sexually Transmitted Disease Surveillance, 1991 (Cent. Dis. Control, Atlanta), Nov/Dec 1992.

4. Sturm, A. W. (1987) J. Antimicrob. Chemother. 19, 187–191.

5. Plummer, F. A., Simonsen, J. N., Cameron, D. W., Ndinya-Achola, J. O., Kreiss, J. K., Gakinya, M. N., Waiyaki, P., Cheang, M., Piot, P., Ronald, A. R. & Ngugi, E. N. (1991) J. Infect. Dis. 163, 233–239.

6. Laga, M., Manoka, A., Kivuvu, M., Malele, B., Tuliza, M., Nzila, N., Goeman, J., Behets, F., Batter, V., Alary, M., Heyward, W. L., Ryder, R. W. & Piot, P. (1993) AIDS 7, 95–102.

7. Cameron, D. W., D'Costa, L. J., Maitha, G. M., Cheang, M., Piot, P.,



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