HIV-1 antibody 3BNC117 suppresses viral rebound in humans during treatment interruption | |
Article | |
关键词: BROADLY NEUTRALIZING ANTIBODIES; ANTIRETROVIRAL THERAPY; MONOCLONAL-ANTIBODIES; GENETIC-DETERMINANTS; PASSIVE TRANSFER; POTENT; SEQUENCE; REPLICATION; RESPONSES; IMMUNOTHERAPY; | |
DOI : 10.1038/nature18929 | |
来源: SCIE |
【 摘 要 】
Interruption of combination antiretroviral therapy in HIV-1-infected individuals leads to rapid viral rebound. Here we report the results of a phase IIa open label clinical trial evaluating 3BNC117, a broad and potent neutralizing antibody against the CD4 binding site of the HIV-1 Env protein(1), during analytical treatment interruption in 13 HIV-1-infected individuals. Participants with 3BNC117-sensitive virus outgrowth cultures were enrolled. Results show that two or four 30 mg kg(-1) 3BNC117 infusions, separated by 3 or 2 weeks, respectively, are generally well tolerated. Infusions are associated with a delay in viral rebound of 5-9 weeks after two infusions, and up to 19 weeks after four infusions, or an average of 6.7 and 9.9 weeks, respectively, compared with 2.6 weeks for historical controls (P < 0.00001). Rebound viruses arise predominantly from a single provirus. In most individuals, emerging viruses show increased resistance, indicating escape. However, 30% of participants remained suppressed until antibody concentrations waned below 20 mu g ml(-1), and the viruses emerging in all but one of these individuals showed no apparent resistance to 3BCN117, suggesting failure to escape over a period of 9-19 weeks. We conclude that the administration of 3BNC117 exerts strong selective pressure on HIV-1 emerging from latent reservoirs during analytical treatment interruption in humans.
【 授权许可】
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