Posted on Oct 01, 2018, 9 p.m.
Combination antibody therapy of a new generation of broadly neutralizing antibodies provides novel approach to treating HIV resulting in long term viral suppression in HIV infection, as published in Nature and Nature Medicine.
A key part to management of HIV infection is antiretroviral drugs, due to the vapid development of viral resistance against agents these drugs need to be administered in combinations. Currently approved drugs are active inhibitors of viral replication requiring daily and life long doses.
Broadly neutralising antibodies have longer half lives and directly target the virus. Two of these antibodies: 3BNC117 and 10-1074 were administered individually in previous clinical trials, and were well tolerated resulting in significant reductions of the viral load, only having transient effects on the viral load and was associated with development of viral resistance.
This study investigated administration of a combination of 3BNC117 and 10-1074 in 30 HIV infected patients with infusions administered up to three times per individuals that were well tolerated by all subjects. HIV infected subjects who were not taking antiretroviral drugs at the beginning of the trial taking the combination resulted in substantial reductions of viral load; administered to another group who paused previous treatment with regular antiretroviral drugs which typically results in rapid return of HIV blood no viremia was detectable in many of the subjects for several months after last infusion of the antibody combination.
According to the researchers results show potential for antibody combinations to maintain long term control of HIV. Based on these results novel approaches for antibody mediated therapy for HIV infection are under consideration which may allow for long term control of the virus without the need for daily doses of medication. Additional clinical trials investigating additional approaches to using broadly neutralising antibodies and HIV infection are currently being conducted.
Materials provided by German Center for Infection Research.
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Pilar Mendoza, Henning Gruell, Lilian Nogueira, Joy A. Pai, Allison L. Butler, Katrina Millard, Clara Lehmann, Isabelle Suárez, Thiago Y. Oliveira, Julio C. C. Lorenzi, Yehuda Z. Cohen, Christoph Wyen, Tim Kümmerle, Theodora Karagounis, Ching-Lan Lu, Lisa Handl, Cecilia Unson-O’Brien, Roshni Patel, Carola Ruping, Maike Schlotz, Maggi Witmer-Pack, Irina Shimeliovich, Gisela Kremer, Eleonore Thomas, Kelly E. Seaton, Jill Horowitz, Anthony P. West, Pamela J. Bjorkman, Georgia D. Tomaras, Roy M. Gulick, Nico Pfeifer, Gerd Fätkenheuer, Michael S. Seaman, Florian Klein, Marina Caskey, Michel C. Nussenzweig. Combination therapy with anti-HIV-1 antibodies maintains viral suppression. Nature, 2018; 561 (7724): 479 DOI: 10.1038/s41586-018-0531-2