HIV Reactivation after Partial Protection by Neutralizing Antibodies

Authors:

• Parsons, Matthew S.
• Cromer, Deborah
• Davenport, Miles P.
• Kent, Stephen J.

Details:

Trends in Immunology, Volume 39, Issue 5, 2018-05-31

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It is widely thought that generating broadly neutralizing anti-HIV antibodies (BnAbs) will protect humans against HIV, given promising data from in vitro experiments and in vivo macaque studies. The primary action of BnAbs is preventing cell-free virus from entering cells. Recent in vitro and macaque data suggest that BnAbs are less potent against cell-associated virus exposure. We speculate that BnAb-based suppression of HIV transmission, particularly if mediated by cell–cell transmission, may result in some exposed subjects carrying a form of latent (or ‘occult’) HIV infection. Such largely hidden HIV infections may subsequently reactivate when BnAb levels decline. This concept has implications for the achievement of long-term sterilizing immunity to HIV.