HIV Remission: bNAbs and Sustained ART-Free

Scientists have been researching HIV for nearly 40 years. But unfortunately, they have not been able to create a vaccine for HIV-1, the virus that causes AIDS. There are a few reasons why.

The challenges of creating an HIV vaccine

One challenge is that HIV-1 has many different variations or types. This makes it hard to create a vaccine that works against all of them. HIV-1 is also good at avoiding the immune system. It is rare for the immune system to make powerful antibodies that can counteract the effects of the virus.¹

Researchers are now studying new approaches to creating vaccines that can activate and enhance the production of these antibodies.

What are bNAbs?

Antibodies are special proteins that your immune system makes when you get sick from things like a virus or bacteria. They spot and attack harmful germs, attaching to them to help you get better.²

Broadly neutralizing antibodies, or bnAbs, are an uncommon yet powerful type of antibody. They have the potential to fight off many different kinds of HIV-1 and stop them from causing infection. Some people with HIV have naturally occurring bNAbs, but the amounts are typically too small to help. Or they form too long after transmission to keep the virus from copying itself and mutating.^1,3

Scientists are working to develop strategies that prompt the immune system to create bNAbs. And they are looking at ways to encourage the immune system to make specific variations needed for the antibodies to fight successfully HIV-1. Beyond HIV, research shows the most successful vaccines today use neutralizing antibodies as their main protection method.¹

bNAbs and ART-free HIV remission

Scientists are now carrying out studies of bNAbs. They want to know if regular infusions or injections of the antibodies can keep HIV in check, even after people stop taking antiretroviral therapy (ART). Scientists are developing bNAbs that are more powerful and last longer in the body. They are also testing combo treatments that would include multiple bNAbs.³

In a 2018 study, published in Nature, researchers tested a bNAb combo treatment on a small group of people living with HIV. They received multiple infusions of the antibody, and the results were promising. The virus was suppressed for at least 4 months after the study participants stopped ART. Despite these advances, it will still be a complex challenge to develop an HIV-1 vaccine. Scientists will use modified mRNAs and other vaccine technologies.^1,4

Right now, most people with HIV need to take ART to maintain their health and avoid transmitting the virus to other people. ART is a daily treatment, typically made up of multiple drugs. While a cure for HIV is the ultimate goal, another option is remission without the need for ART. Remission means the virus is suppressed, and you do not have to take daily medicine.³