Induction of durable remission by dual immunotherapy in SHIV-infected ART-suppressed macaques

Author:

Lim So-Yon1ORCID,Lee Jina1ORCID,Osuna Christa E.1ORCID,Vikhe Pratik1ORCID,Schalk Dane R.2ORCID,Chen Elsa1,Fray Emily3ORCID,Kumar Mithra3ORCID,Schultz-Darken Nancy2ORCID,Rakasz Eva2ORCID,Capuano Saverio2,Ladd Ruby A2ORCID,Gil Hwi Min2ORCID,Evans David T.2ORCID,Jeng Emily K.4,Seaman Michael1ORCID,Martin Malcolm5ORCID,Van Dorp Christiaan6ORCID,Perelson Alan S.67ORCID,Wong Hing C.4,Siliciano Janet D.3ORCID,Siliciano Robert38ORCID,Safrit Jeffrey T.9,Nixon Douglas F.10ORCID,Soon-Shiong Patrick9ORCID,Nussenzweig Michel1112ORCID,Whitney James B.113ORCID

Affiliation:

1. Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.

2. Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, WI 53715, USA.

3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.

4. Altor Biosciences, Miramar, FL 33027, USA.

5. Laboratory of Molecular Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

6. Los Alamos National Laboratory, Los Alamos, NM 87545, USA.

7. Santa Fe Institute, Santa Fe, NM 87501, USA.

8. Howard Hughes Medical Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.

9. ImmunityBio, Culver City, CA 90232, USA.

10. Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA.

11. Laboratory of Molecular Immunology, The Rockefeller University, New York, NY 10065, USA.

12. Howard Hughes Medical Institute, The Rockefeller University, New York, NY 10065, USA.

13. Department of Biology, Boston College, Chestnut Hill, MA 02467, USA.

Abstract

The eradication of the viral reservoir represents the major obstacle to the development of a clinical cure for established HIV-1 infection. Here, we demonstrate that the administration of N-803 (brand name Anktiva) and broadly neutralizing antibodies (bNAbs) results in sustained viral control after discontinuation of antiretroviral therapy (ART) in simian-human AD8 (SHIV-AD8)–infected, ART-suppressed rhesus macaques. N-803+bNAbs treatment induced immune activation and transient viremia but only limited reductions in the SHIV reservoir. Upon ART discontinuation, viral rebound occurred in all animals, which was followed by durable control in approximately 70% of all N-803+bNAb–treated macaques. Viral control was correlated with the reprogramming of CD8 + T cells by N-803+bNAb synergy. Thus, complete eradication of the replication-competent viral reservoir is likely not a prerequisite for the induction of sustained remission after discontinuation of ART.

Publisher

American Association for the Advancement of Science (AAAS)

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