Evaluating the Role of IgG1 Broadly Neutralizing Antibodies as Alternatives to Combination Antiretroviral Therapy in HIV Treatment

Human immunodeficiency virus (HIV) is a sexually transmitted infection which significantly impairs the immune system's ability to mount a defense against pathogens. While there is currently no cure, the conventional therapy is an anti-retroviral combination therapy consisting of zidovudine, lamivudine, and indinavir. Following the emergence of monoclonal antibody therapies, the IgG1 broadly neutralizing antibody (bnAb) asdirected at the HIV type 1 (HIV-1) envelope protein CD4-binding site, VRC01, has been discussed as a potential therapy for HIV. A systematic review was then conducted utilizing a research study of patients which had HIV and were treated with combined antiretroviral compared to one in which the patients were treated with VRC01. Patients who were treated with VRC01 experienced greater reductions in HIV viral load than did those who were treated with the combined antiretroviral therapy. This alludes to the fact that the envelope protein CD4-binding of the HIV virus prior to its entry into the cell is much more heavily implicated in the disease’s pathogenesis than its reverse transcription or integration into the host’s genome. While a preliminary evaluation of the two agents seems to suggest that VRC01 is superior to conventional combined antiretroviral therapy, it must be noted that the study which subjected participants to VRC01 had an incredibly small sample size. More studies utilizing greater amounts of participants and over longer courses of time must be conducted to make this determination with more confidence.