Broadly Neutralizing Antibody Therapy for HIV-1 Treatment and Long-Term Viral Remission

Rukundo Sande Kibuuka

 

Faculty of Science and Technology Kampala International University Uganda

ABSTRACT

Human immunodeficiency virus type 1 (HIV-1) infection affected approximately 38 million individuals globally, with lifelong antiretroviral therapy required to suppress viral replication. Despite effective viral suppression, antiretroviral therapy does not eradicate latent viral reservoirs, necessitating continuous treatment and failing to achieve a functional cure. Broadly neutralizing antibodies (bNAbs) represented a novel therapeutic modality capable of targeting multiple HIV-1 strains through recognition of conserved envelope glycoprotein epitopes, offering potential mechanisms beyond direct viral neutralization, including antibody-dependent cellular cytotoxicity and immune complex formation. This review critically evaluated the biochemical properties, antiviral mechanisms, clinical efficacy, reservoir reduction capacity, and translational potential of broadly neutralizing antibodies for HIV-1 treatment and achievement of sustained viral remission without continuous antiretroviral therapy. A comprehensive literature search was conducted across PubMed, Embase, and Scopus databases for peer-reviewed articles published between 2014 and 2024, focusing on broadly neutralizing antibody immunotherapy, HIV-1 remission strategies, and latent reservoir targeting. Broadly neutralizing antibodies demonstrated potent in vitro neutralization breadth exceeding 90% of circulating HIV-1 strains, with clinical studies showing transient viral suppression during analytical treatment interruption when administered as monotherapy or combination regimens. Single infusions achieved plasma half-lives of 15 to 71 days, maintaining suppressive concentrations for 2 to 6 months. However, viral rebound occurred in most participants within 4 to 12 weeks post-antibody clearance, attributed to persistent latent reservoirs and emergence of resistant viral variants. Combination bNAb regimens and concurrent administration with latency reversal agents showed enhanced reservoir reduction and delayed viral rebound in subset analyses. Broadly neutralizing antibodies demonstrated proof-of-concept for antibody-mediated HIV-1 control but require optimization through combination strategies, reservoir targeting approaches, and identification of predictive biomarkers for sustained remission.

Keywords: Broadly neutralizing antibodies, HIV-1 remission, Latent reservoir, Antiretroviral therapy, Functional cure.

CITE AS: Rukundo Sande Kibuuka (2026). Broadly Neutralizing Antibody Therapy for HIV-1 Treatment and Long-Term Viral Remission. IDOSR JOURNAL OF BIOLOGY, CHEMISTRY AND PHARMACY 11(1):99-105. https://doi.org/10.59298/IDOSR/JBCP/26/102.99105