Broadly neutralizing antibodies for the treatment of HIV infection

Abstract

Antibodies with neutralizing activity against a wide range of human immunodeficiency virus 1 subtypes (known as broadly neutralizing antibodies — bNAb) are of great interest as a therapeutic agent for the treatment of HIV infection, because they are able to provide natural protection against most HIV-1 strains. The review discusses the mechanisms of formation of bNAbs, their classification by binding to conservative regions of the envelope protein, as well as their intrinsic features. Description of the most promising bNAbs and their combinations is presented.In the last section the results of clinical trials of 3BNC117, VRC01 and 10-1074 bNAbs available to date are reviewed in detail. An important finding of these studies was that the introduction of a single antibody is followed by the appearance of resistant viral variants. The investigation of the only combination of 3BNC117 and 10-1074 completed so far indicates that combined therapy is more effective and allows to achieve long-term viral suppression in some patients. The promise of combined HIV immunotherapy is evidenced by the initiation of a large number of clinical trials evaluating the efficacy of two or more different bNAbs.