Antiretroviral therapy is highly effective in suppressing human immunodeficiency virus (HIV)
. However, eradication of the virus in individuals with HIV has not been possible to date
. Given that HIV ...suppression requires life-long antiretroviral therapy, predominantly on a daily basis, there is a need to develop clinically effective alternatives that use long-acting antiviral agents to inhibit viral replication
. Here we report the results of a two-component clinical trial involving the passive transfer of two HIV-specific broadly neutralizing monoclonal antibodies, 3BNC117 and 10-1074. The first component was a randomized, double-blind, placebo-controlled trial that enrolled participants who initiated antiretroviral therapy during the acute/early phase of HIV infection. The second component was an open-label single-arm trial that enrolled individuals with viraemic control who were naive to antiretroviral therapy. Up to 8 infusions of 3BNC117 and 10-1074, administered over a period of 24 weeks, were well tolerated without any serious adverse events related to the infusions. Compared with the placebo, the combination broadly neutralizing monoclonal antibodies maintained complete suppression of plasma viraemia (for up to 43 weeks) after analytical treatment interruption, provided that no antibody-resistant HIV was detected at the baseline in the study participants. Similarly, potent HIV suppression was seen in the antiretroviral-therapy-naive study participants with viraemia carrying sensitive virus at the baseline. Our data demonstrate that combination therapy with broadly neutralizing monoclonal antibodies can provide long-term virological suppression without antiretroviral therapy in individuals with HIV, and our experience offers guidance for future clinical trials involving next-generation antibodies with long half-lives.
Antiretroviral therapy (ART) is highly effective in suppressing human immunodeficiency virus (HIV)
1
; however, eradication of the virus in infected individuals has not been possible thus far
2
. ...Given that HIV suppression requires life-long ART, predominantly on a daily basis, there is a need to develop clinically effective alternatives that utilize long-acting antiviral agents to inhibit viral replication
3
. Here, we report the results of a two-component clinical trial involving passive transfer of two HIV-specific broadly neutralizing monoclonal antibodies (bNAbs) 3BNC117 and 10–1074. The first component was a randomized, double-blind, placebo-controlled trial that enrolled participants who initiated ART during the acute/early phase of HIV infection. The second component was an open-label single arm trial that enrolled ART-naive viremic controllers. Up to 8 infusions of 3BNC117 and 10–1074, administered over a period of 24 weeks, were well-tolerated without any serious adverse events related to the infusions. Compared with placebo, the combination bNAbs maintained complete suppression of plasma viremia (up to 43 weeks) following analytical treatment interruption (ATI), provided that no antibody-resistant HIV was detected at baseline in the study participants. Similarly, potent HIV suppression was seen in the ART-naïve, viremic study participants carrying sensitive virus at baseline. Our data demonstrate that combination bNAb therapy can provide long-term ART-free virologic suppression in infected individuals and our experience offers guidance for future clinical trials involving next generation antibodies with long half-lives.
