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HIV therapy by a combination of broadly neutralizing antibodies in humanized mice

Abstract

Human antibodies to human immunodeficiency virus-1 (HIV-1) can neutralize a broad range of viral isolates in vitro and protect non-human primates against infection1,2. Previous work showed that antibodies exert selective pressure on the virus but escape variants emerge within a short period of time3,4. However, these experiments were performed before the recent discovery of more potent anti-HIV-1 antibodies and their improvement by structure-based design5,6,7,8,9. Here we re-examine passive antibody transfer as a therapeutic modality in HIV-1-infected humanized mice. Although HIV-1 can escape from antibody monotherapy, combinations of broadly neutralizing antibodies can effectively control HIV-1 infection and suppress viral load to levels below detection. Moreover, in contrast to antiretroviral therapy10,11,12, the longer half-life of antibodies led to control of viraemia for an average of 60 days after cessation of therapy. Thus, combinations of potent monoclonal antibodies can effectively control HIV-1 replication in humanized mice, and should be re-examined as a therapeutic modality in HIV-1-infected individuals.

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Figure 1: Monotherapy using broadly neutralizing antibodies in HIV-1 YU2 -infected humanized mice.
Figure 2: HIV therapy by a combination of three (tri-mix) or five (penta-mix) broadly neutralizing antibodies in HIV-1 YU2 -infected humanized mice.
Figure 3: Viral rebound in HIV-1 YU2 -infected humanized mice after cessation of antibody therapy.

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Acknowledgements

We thank R. Kaiser for analysing viral loads of reference HIV-1 samples and N. N. Freund for producing YU2 gp120. We thank B. Flatley, T. Friling, H. Gao, S. Sell and S. Hinklein for assistance and technical support, M. Suarez-Farinas for advice on statistical analysis, and M. Babayeva for helping with antibody t1/2 estimation. M.C.N. and F.K. have a pending patent application for the antibody 3BC176 and M.C.N., P.J.B. and H.M. for the antibody 10-1074 with the United States Patent and Trademark Office. These reagents are available with a Material Transfer Agreement. F.K. (KL 2389/1-1), M.D. (DO 1450/1-1) and E.B. (BI 1422/1-1) were supported by the German Research Foundation (DFG). H.G., C.G. and R.-B.I. were supported by The German National Academic Foundation. M.S.S. was supported by the Bill and Melinda Gates Foundation’s Comprehensive Antibody Vaccine Immune Monitoring Consortium, grant number 1032144. A.P. is a recipient of a Liver Scholar Award from the American Liver Foundation. This work was supported in part by CAVD grant OPP1033115 from the Bill and Melinda Gates Foundation to M.C.N., in part by NIAID 1UM1AI100663 to M.C.N. and NIH grant AI081677 to M.C.N. M.C.N., P.J.B. and P.D.B. are HHMI investigators.

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F.K., A.H.-S. and J.A.H. planned and performed experiments and wrote the manuscript. H.G., J.F.H., S.B., H.M., L.A.S., R.D., A.A., T.Z., M.D., E.B., R.N.L., C.G., P.M.M., R.-B.I., T.R.E. and M.S.S. performed experiments. P.D.B., P.J.B., J.V.R. and A.P. provided reagents, advice and edited the manuscript. M.C.N. planned experiments and wrote the manuscript.

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Correspondence to Michel C. Nussenzweig.

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The authors declare no competing financial interests.

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Klein, F., Halper-Stromberg, A., Horwitz, J. et al. HIV therapy by a combination of broadly neutralizing antibodies in humanized mice. Nature 492, 118–122 (2012). https://doi.org/10.1038/nature11604

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