Combination anti-HIV-1 antibody therapy is associated with increased virus-specific T cell immunity.

Niessl, Julia; Baxter, Amy E; Mendoza, Pilar; Jankovic, Mila; Cohen, Yehuda Z; Butler, Allison L; Lu, Ching-Lan; Dubé, Mathieu et al. · Nat Med · 2020

rct · Level II

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Abstract

Combination antiretroviral therapy (ART) is highly effective in controlling human immunodeficiency virus (HIV)-1 but requires lifelong medication due to the existence of a latent viral reservoir<sup>1,2</sup>. Potent broadly neutralizing antibodies (bNAbs) represent a potential alternative or adjuvant to ART. In addition to suppressing viremia, bNAbs may have T cell immunomodulatory effects as seen for other forms of immunotherapy<sup>3</sup>. However, this has not been established in individuals who are infected with HIV-1. Here, we document increased HIV-1 Gag-specific CD8<sup>+</sup> T cell responses in the peripheral blood of all nine study participants who were infected with HIV-1 with suppressed blood viremia, while receiving bNAb therapy during ART interruption<sup>4</sup>. Increased CD4<sup>+</sup> T cell responses were detected in eight individuals. The increased T cell responses were due both to newly detectable reactivity to HIV-1 Gag epitopes and the expansion of pre-existing measurable responses. These data demonstrate that bNAb therapy during ART interruption is associated with enhanced HIV-1-specific T cell responses. Whether these augmented T cell responses can contribute to bNAb-mediated viral control remains to be determined.

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