The Place of Broadly Neutralizing Antibodies in the Cure for HIV

While antiretroviral therapy (ART) effectively suppresses HIV and prevents progression to AIDS, it does not eliminate the virus, leading to viral rebound if the patient stops taking ART. In recent years, broadly neutralizing antibodies (bNAbs) have emerged as potential candidates to provide a more functional treatment or, possibly, a cure for HIV, given their longevity, proven safety and tolerability, and ability to neutralize a wide range of HIV strains. This review aims to gather information on bNAbs’ performances in clinical trials, present challenges with utilizing bNAbs, and discuss methods to improve the ability of bNAbs to maintain viral suppression. Although monotherapy with a single bNAb was able to significantly reduce viral load for a short period of time, this treatment could not adequately prevent viral rebound or viral resistance. With greater breadth and less viral resistance, combination therapy with complementary bNAbs looks to be a more viable option than monotherapy. Additionally, there have been several improvements to bNAbs achieved by modifying specific regions on antibodies, causing the modified antibodies to have longer half-lives or greater potency.