The Rise of Broadly Neutralizing Antibodies

Bill Snow founded AVAC and is the former Global HIV Vaccine Enterprise Executive Director.

Research on broadly neutralizing antibodies (bNAbs) is taking the field of HIV prevention science in new directions, with implications for new prevention interventions and vaccine development. There’s much to know and much to learn about these powerful instruments of the immune system.

Since 2016, more than 2,700 men in Brazil, Peru, Switzerland and the US, and 1,900 women in Southern Africa have begun to enroll in clinical trials looking at antibody-mediated prevention, or AMP (see Figure 1). A collaboration between the HIV Prevention Trials Network (HPTN) and HIV Vaccine Trials Network (HVTN) (both funded by the National Institutes of Health), the AMP studies test the safety and efficacy of the broadly neutralizing antibody (bNAb) VRC01 when it is given every 8 weeks to reduce the risk of HIV infection. But how did this approach come about, why is it important and what may happen next with bNAbs for HIV prevention?


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What’s an antibody?

Antibodies are Y-shaped proteins produced by B cells to clear infected cells and pathogens in the bloodstream. B cells are part of what is known as the adaptive immune system, which mounts defenses aimed at specific invaders—like a cold virus or chicken pox or HIV. The innate immune system also defends against invaders, but its defenses are not so finely tailored to a specific pathogen. When a virus encounters the right B cell, the B cell begins cloning itself and produces antibodies designed to battle that virus. These antibodies circulate throughout the body looking for the virus, and they evolve continuously, becoming ever more precise and numerous.

The Antibody Hierarchy

Here are some terms that will help you follow this ongoing story:

  • Antibody: Proteins produced by B cells as a major part of the adaptive human immune defense against specific invaders.
  • Binding antibody: An antibody that attaches to a virus but doesn’t necessarily render it ineffective; can be driven by the innate immune system.
  • Monoclonal antibody: A bioengineered antibody made in a manufacturing facility by copying (cloning) one original antibody—selected for its potency and other characteristics.
  • Neutralizing antibody: Antibody that disables virus.
  • Broadly neutralizing antibody: An antibody that neutralizes many different genetic variants of HIV.
  • Passive antibodies: A dose of monoclonal antibodies that are infused or injected, rather than made by one’s own immune system.

Vaccines Efficacy Trials: A surge of activity

A picture of the status of vaccine trials since 2003: The four trials shown here represent an unprecedented number of late phase trials underway in vaccines research.

Vaccine and Antibody Trial Participant Recruitment, 2018

A global snapshot of total numbers of participants in trials by country.

Prevention Research & Oral PrEP Rollout: The evolving context for HIV prevention research

Many of the current or planned prevention trials are taking place in countries where daily oral PrEP is available or will be soon. This infographic shows the status PrEP and the location of scheduled trials by country.

US HIV Research: A family tree

This graphics shows a family tree representing HIV research in the United States. It appears in AVAC Report 2017: Mixed messages and how to untangle them.

Timeline for DAIDS HIV Trials Network Recompetition

This graphic looks ahead from 2017 through 2027 at the DAIDS HIV Trials Network Recompetition process. It appears in AVAC Report 2017: Mixed messages and how to untangle them.

Evolving Context for HIV Prevention Research (Map)

A global map showing selected HIV prevention research and oral PrEP status.

Advocacy in Uncertain Times: A call to action

It’s almost here! HIV Vaccine Awareness Day (HVAD) is upon us. This Thursday will mark the day’s 20th anniversary and cap off AVAC’s month-long “vaccine immersion”. On Thursday, we will host the final webinar in our series, featuring Julie Ake of the US Military HIV Research Program. (Update: link to the recording.)

HVAD comes amidst a week when advocates for health and human rights are aghast at a new US guideline on expansion of the Global Gag Rule—a policy that is anti-woman and anti-public health, and that will now impact many more recipients of US funding. As AVAC states in a blog, we are committed to the rights and health of girls and women worldwide, and stand strong with our allies in this fight.

Our HVAD resources are designed for allies everywhere to use in the fight for rights-based, science-forward, sustainable solutions to the epidemic. They include our updated HVAD toolkit, which features our HVAD call to action, Advocacy in Uncertain Times, a new publication on HIV vaccine advocacy and priorities for the field—required reading for HIV prevention and vaccine advocates alike!

HVAD 2017 Toolkit

  • Advocacy in Uncertain Times: A call to action—AVAC’s report for HVAD on the state of the HIV vaccine research and development field, including key priorities for advancing research and sustaining support. (Click here to download all graphics from this report.)
  • HIV Vaccines: Key Messages for HVAD 2017—Bullet points on today’s pressing issues; great for informed audiences who need compelling outreach messages.
  • HIV Vaccines: An Introductory Fact Sheet—Part of AVAC’s basic fact sheet series, a two-pager of basic information and research updates; great for distribution to lay audiences.
  • HIV Vaccines: The Basics—Introductory PowerPoint slide set with basic concepts, an overview of research status and recent developments; great for use by research representatives and vaccine stakeholders for presenting information to wider audiences.
  • Vaccine Science for Busy Advocates: bNAbs—a one-pager reviewing highlights, next steps and key terms; great for lay audiences who are looking to understand complex technical issues.

Missed any of the previous webinars in the series? Visit www.avac.org/hvad for the slides and recordings.

And HVAD is active on social media this year! Follow the hashtags #HIVVaccineAware and #HVAD2017 on Twitter and Facebook for more messages and resources this HVAD.

At AVAC, we thank you for your work and partnership today and every day. We’re committed to ending the AIDS epidemic, and that means finding an HIV vaccine. We couldn’t do it without you.

HIV-Specific Neutralizing Antibodies: A guide to targets and candidates

A detailed graphic describing the status of pre-clinical and clinical work around relevant bNAbs today.

Where Does Oral PrEP Fit in to Vaccine and AMP Trials?

A global map showing current efficacy trial countries and their status of PrEP implementation.