bNAb May Hold the Key to HIV Cure, Vaccine

HIV is still a large public health problem. After 30 years, there still is no cure for infection and no vaccine to prevent infection. But why has it been so difficult to produce such treatments and vaccines? This was the topic of the Bernard Fields Lecture yesterday at the Conference on Retroviruses and Opportunistic Infections (CROI) 2019.

Michel C. Nussenzweig, MD, PhD, from the Rockefeller University in New York, New York, spoke about the “Discovery and Development of HIV Broadly Neutralizing Antibodies.”

Dr Nussenzweig said that “Most vaccines are antibody-based, and for a long time, it was very difficult to find a potent broadly neutralizing antibody against HIV.”

Through research Dr Nussenzweig and his team has conducted, they found that some people develop broadly neutralizing antibodies to HIV naturally. Therefore, the team developed a method for single-cell antibody cloning that could be tested.

“When people adapted these methods, our lab and many others discovered that there are many very potent and very broad antibodies that people who are infected can make,” Dr Nussenzweig said during his lecture. “And in addition, we as a field discovered that there are many targets, not just the CD4 cell bonding site, that are susceptible to these antibodies.”

Antibodies are expensive to produce, but they may have a role in creating prevention options or treatments for patients with HIV-1 infection. They differ from current antiretroviral therapy in that they are able to engage host immunity, similar to how they are used in cancer treatments.

“In addition to hitting their targets, antibodies also engage the host immune system. So, in cancers, what happens is you get host immunity to eradicate cancer. And that is what we’re looking for in some of [these] therapies,” Dr Nussenzweig said.

Dr Nussenweig also spoke about clinical evaluation of broadly neutralizing antibody therapy for prevention or treatment of HIV-1 infection. He said that in addition to being safe, an effective broadly neutralizing antibody prevention or therapy must have potency and breadth, have adequate pharmacokinetic properties, have good effector-function, and have the ability to limit HIV escape.

Few antibodies have been studied, and therefore, little is known about them clinically; however, there are many antibodies currently in development.

For more information about Dr Nussenzweig’s session, click here.

For more CROI 2019 coverage, click here.

—Amanda Balbi

Reference:

Nussenzweig MC. Discovery and development of HIV broadly neutralizing antibodies. Talk presented at: Conference on Retroviruses and Opportunistic Infections (CROI) 2019; March 4-7, 2019; Seattle, WA. http://www.croiconference.org/sessions/discovery-and-development-hiv-broadly-neutralizing-antibodies. Accessed March 5, 2019.