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Antiretroviral therapy (ART) has come a long way, making a diagnosis of HIV a manageable condition today. Although effective, antiretroviral therapy is not a cure. In addition, there are obstacles to proper use. In order to maintain effective treatment and keep the viral titer at a low level, a patient must follow a strict regime of multiple pills each day.
New clinical trial results suggest that a new antibody-based treatment could potentially target HIV, both for treatment and for prevention. The results of the tests of this new immunotherapy in humans are published in two articles entitled "Combined therapy with antibodies to HIV-1 maintains viral suppression" published in Nature and a related document Medicine of nature entitled "Safety and antiviral activity of HIV-1 association with broad neutralization of antibodies in viremic individuals."
The work was a collaboration of Marina Caskey, M. D., early stage physician and Michel Nussenzweig, M.D., Ph.D., Professor Zanvil A. Cohn and Ralph M. Steinman, both of Rockefeller University; and Florian Klein, M.D., M.Sc., professor and director, institute of virology at the University Hospital of Cologne, Germany.
The work reports a phase Ib clinical trial in which a combination of two potent monoclonal monoclonal anti-HIV-1 (or BNAbs) antibodies, 3BNC117 and 10-1074, targets independent sites on the peak envelope of HIV-1. 1, was administered. interruption of the analytical treatment.
The trial participants stopped taking antiretroviral drugs and subsequently received three infusions of both BNAs in six weeks (at 0, 3 and 6 weeks). Among the nine subjects carrying viruses susceptible to both antibodies, HIV between 15 and 30 weeks, with an average of 21 weeks. In addition, patients with active viremia observed a significant reduction in viral titer for three months. In addition, participants had no major side effects, the most important reaction being mild fatigue in a small proportion of patients.
The new immunotherapy has been shown to be able to suppress HIV for months. In addition, the drugs have been shown to be both safe and more effective than any previously tested antibody treatment.
The antibodies were first identified in people, called "elite controllers," who produce natural antibodies that successfully fight HIV infection without treatment. The idea behind the use of BNAb therapy is to turn people into elite controllers by administering the antibodies that fight the virus.
Two antibodies were used at the same time to fight against the inevitable mutations of viruses that could lead to resistance, rendering the therapy ineffective. Indeed, researchers report that patients receiving combination therapy did not develop resistance if their viruses were antibody-sensitive. In addition, the antibodies remain in the body longer than the ART.
Although very promising, Dr. Caskey says that "these two antibodies will not work for everyone." Dr. Nussenzweig adds that, over time, bNAb therapy may induce the body to produce HIV antibodies itself. anticancer drugs, these drugs may interact with the host's immune system to enhance natural immunity, "he says.
Dr. Nussenzweig added that further research could lengthen the effectiveness of these drugs. Although four months is an impressive time, it could become even longer with new variants of bNAb, revolutionizing the way HIV is treated and prevented. "If future studies succeed in the same way, BBNA could really become a practical alternative to antiretroviral therapy," says Dr. Caskey, "a safe alternative and not requiring a pill every day." A long-acting anti-HIV drug, both treatment and prevention, could alter the state of the HIV epidemic as we know it.
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