HIV-1 antibody 3BNC117 suppresses viral rebound in humans during treatment interruption

Nature. 2016 Jul 28;535(7613):556-60. doi: 10.1038/nature18929. Epub 2016 Jun 22.

Abstract

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, 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 μg 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.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / pharmacology
  • Anti-HIV Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neutralizing / administration & dosage
  • Antibodies, Neutralizing / immunology*
  • Antibodies, Neutralizing / therapeutic use
  • Binding Sites / drug effects
  • Binding Sites / immunology
  • Broadly Neutralizing Antibodies
  • CD4 Antigens / metabolism
  • Disease Reservoirs / virology
  • Drug Administration Schedule
  • Female
  • HIV Antibodies / administration & dosage
  • HIV Antibodies / immunology*
  • HIV Antibodies / therapeutic use
  • HIV Envelope Protein gp160 / antagonists & inhibitors
  • HIV Envelope Protein gp160 / chemistry
  • HIV Envelope Protein gp160 / immunology
  • HIV Envelope Protein gp160 / metabolism
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Infections / virology*
  • HIV-1 / drug effects
  • HIV-1 / growth & development*
  • HIV-1 / immunology*
  • Historically Controlled Study
  • Humans
  • Male
  • Middle Aged
  • Proviruses / drug effects
  • Proviruses / growth & development
  • Proviruses / immunology
  • Time Factors
  • Tissue Distribution
  • Viral Load / drug effects
  • Viral Load / immunology
  • Young Adult

Substances

  • 3BNC117 antibody
  • Anti-HIV Agents
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neutralizing
  • Broadly Neutralizing Antibodies
  • CD4 Antigens
  • HIV Antibodies
  • HIV Envelope Protein gp160