Katharine J. Bar, MD
Associate Professor of Medicine University of Pennsylvania,
Penn CFAR

“HIV-specific antibody responses after early ART initiation: obstacles and opportunities”

HIV-1 has evolved to be uniquely resistant to antibody neutralization, such that antibody responses fail to clear or control the virus. Early initiation of antiretroviral therapy (ART) limits HIV reservoir size and diversity and preserves immunity. We characterized the impact of acute and early ART initiation on the development of HIV-specific antibody responses. We found that acute ART initiation (prior to 60 days) prevented autologous neutralizing antibodies from developing before or on ART. Early ART initiation (60-120 days) allowed neutralizing antibody development prior to ART, which continued to expand in breadth and potency over years of suppressive ART. We found similar antibody kinetics in a nonhuman primate (NHP) model of early ART initiation. Together, results provide optimism that we could use new vaccine techniques to boost autologous antibodies to cover the unique diversity of viruses within early treated NHP and humans.