Waters Laura, de Miguel-Buckley Rosa, Poulin Sébastien, Arribas Jose R
Department of Sexual Health & HIV, Central & North West London NHS Trust, London, United Kingdom.
Infectious Diseases Unit, Internal Medicine Department, La Paz University Hospital, IdiPAZ, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
Clin Infect Dis. 2023 Mar 21;76(6):1136-1141. doi: 10.1093/cid/ciac835.
In this viewpoint, we briefly review the status of antiretroviral therapy (ART), its unmet needs, and the role that broadly neutralizing antibodies (bNAbs) might have in the near future for the treatment of human immunodeficiency virus (HIV). We summarize advances in the development of bNAbs as antiretroviral therapy, the results of main clinical trials of bNAbs for HIV treatment and prevention, and its role in cure trials. The limitations of broadly neutralizing antibodies are the current need for primary resistance testing, the still unclear number of antibodies that must be combined, the lack of penetration in anatomical reservoirs, and the role they might play in cure studies. We compare the advantages and disadvantages of "classical ART" and therapy based on broadly neutralizing antibodies. We conclude that broadly neutralizing antibodies still need considerable improvements before they can be considered an alternative to classical ART.
在本观点文章中,我们简要回顾抗逆转录病毒疗法(ART)的现状、其尚未满足的需求,以及广泛中和抗体(bNAbs)在不久的将来可能在人类免疫缺陷病毒(HIV)治疗中发挥的作用。我们总结了bNAbs作为抗逆转录病毒疗法的研发进展、bNAbs用于HIV治疗和预防的主要临床试验结果,以及其在治愈试验中的作用。广泛中和抗体的局限性在于目前需要进行原发性耐药性检测、必须联合使用的抗体数量仍不明确、在解剖学储存库中的渗透不足,以及它们在治愈研究中可能发挥的作用。我们比较了“经典ART”和基于广泛中和抗体的疗法的优缺点。我们得出结论,在广泛中和抗体能够被视为经典ART的替代方案之前,仍需要进行相当大的改进。