The development of innovative, reliable HIV prevention and treatment protocols remain primary goals for members of the scientific community. Sure, significant advances have been made towards the management of HIV and the eradication of the pandemic. Still, more work has to be done to guarantee consistency, efficiency and ready availability of treatment options.
HIV broadly neutralizing antibodies have been studied for some time due to their properties and effects. A new study shows a lot of promise, suggesting that such antibodies can be used for the development of a long-acting HIV treatment.
What Are HIV Broadly Neutralizing Antibodies?
Antiretroviral therapy (ART) is currently the most effective treatment for HIV patients. Many people who go on ART register a significant viral load reduction that even leads to the confirmation of a HIV-negative status (whenever ART is initiated very early and taken consistently for a couple of years).
The problem with ART is that the medications have to be taken for life. The moment a person discontinues their therapy is the moment in which viral replication commences once again.
HIV broadly neutralizing bodies (bNAbs)have been studied as an alternative for some time now. As the name suggests, these are antibodies that can neutralize various types of human immunodeficiency viral strains.
If present at the time of a viral exposure, bNAbs can block an infection. These properties make the antibodies very promising in the eyes of researchers. Also, there are a couple of important ways in which they’re different from antiretroviral medications.
In comparison to current ART, bNAbs offer reduced toxicity, extended half-lives that completely eliminate the need for the administration of a daily dose and the potential to incorporate a much broader immune response.
The Latest Clinical Studies on HIV bNAbs
The theory is easy to understand but is there any evidence that HIV bNAbs can actually deliver the anticipated outcomes?
Researchers presented their latest findings on the topic during the November 2022 HIV Drug Therapy meeting.
The study focused on a type of broadly neutralizing antibody known as N6LS. This phase II clinical trial involved 14 previously untreated participants who received either a high or a low dose of N6LS.
Previous research suggests that N6LS targets the CD4 binding site on the envelope of the human immunodeficiency virus. What this means is that the antibody prevents the virus from entering the CD4 cell and replicating there. In previous lab studies, the antibody has demonstrated both broad and a very powerful neutralizing effect.
In the latest trial, 13 out of the 14 participants had a positive response. When they entered the experiment, all the volunteers had a viral load of 5,000 or higher. They had never taken ART and their CD4 count was 250 or higher.
After receiving a single dose of N6LS, both people who received a high and a low dose of the antibody exhibited a very strong antiviral response. The response was evident in all eight participants on a high dose of N6LS and in three of the four participants who received the low dose. A median reduction in the viral load was set at 1.72 log and 1.18 log respectively for the high and the low dose treatment groups. On the average, the virus needed 35 days to rebound after the administration of the antibody.
It’s also very important to mention that the treatment was tolerated well and the researchers deemed it safe for all the participants in the trial. There were some side effects (ranging from abdominal pain to injection side reaction) but none of the experiences were severe.
N6LS isn’t the only HIV broadly neutralizing antibody that is being studied for its effectiveness. Various bNAbs exist and some of those are considered good candidates for the development of HIV prevention, treatment and remission protocols.
Some of the bNAbs like N6LS target the CD4 binding site on the viral envelope. Others are glycan-dependent bNAbs (considered a very strong candidate for the development of a long-awaited HIV vaccine). There are other categories of bNAbs, as well. They work in very complex ways but the end goal is to have a neutralizing impact on the virus, keeping it from replicating in the immune cells of the host.
For some time, bNAbs have been evaluated using animal models – a very important approach in HIV research. In chimpanzees treated with bNAbs, infection was preventable. It did occur after a very prolonged infection. Humanised mouse models were also developed to carry out relevant research. These have also proven beneficial to establish an infection prevention effect.
More thorough and comprehensive human trials will now be needed to learn more about bNAbs, their safety, effectiveness and practical applicability in the world of HIV treatment development. What we do know right now, however, suggests that antibodies have a massive potential, offering a well-tolerated and reliable alternative to ART.
The Changing World of HIV Care: A Revolution in the Making
While we wait for innovation to show its practical potential in the world of HIV care, it’s very important to understand the fact that such a diagnosis is no longer a death sentence.
HIV-positive individuals who know their status early enough and undertake adequate measures can enjoy long, healthy and fulfilling lives. Antiretroviral medications are available across the world and Singaporean patients have access to some of the best treatments.
Prevention is also possible, thank to options like HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). These antiretroviral treatments are meant to be applied before or after risky contact, reducing the chance for an actual infection by more than 99 per cent.
This is why getting tested for HIV and knowing your status is very important early on. The sooner you know, the sooner you can start taking care of yourself and of the people you love.
At Shim Clinic, you’ll find thorough information HIV testing opportunities and additional chances to get screened for STDs and get on top of your sexual health. Visit Shim Clinic during working hours every day of the week or contact us now to have your questions answered.