A collaboration between the US National Institutes of Health (NIH) and the pharmaceutical company Sanofi has resulted in the engineering of an antibody that attacks 99% of human immunodeficiency virus (HIV) strains and can prevent infection in primates.

In the antibody tests on 24 monkeys, none of those given the tri-specific antibody developed an HIV infection when later injected with the virus.

By combining antibodies, the researchers created a “tri-specific antibody,” each of which binds to a critical site on the HIV to overcome the virus’ defenses.  Dr. Gary Nabel, the chief scientific officer at Sanofi, reported in a BBC News website interview, “These super-engineered antibodies seem to go beyond the natural and could have more applications than we have imagined to date. They are more potent and have greater breadth than any single naturally occurring antibody that’s been discovered.”

Researchers have been struggling to develop an HIV vaccine for years. Because of the virus’ incredible ability to mutate, such a vaccine has been elusive—(perhaps) until now.

HIV is believed to have originated around 1920 in the Democratic Republic of Congo when HIV crossed species from chimpanzees to humans.  Quietly, the disease spread because HIV was unknown and transmission was unaccompanied by noticeable signs or symptoms. By the 1980s the disease had spread to five continents (Africa, Australia, Europe, North America, and South America). Because the disease was unknown, data was not available for numbers of cases before the 1980s, but estimates are that as many as 300,000 people were already infected by 1980.

In April 1984, the National Cancer Institute (NCI) announced the discovery of the cause of acquired immunodeficiency syndrome (AIDS), the HTLV-III retrovirus. The retrovirus leads to HIV infection. This infection attacks the immune system and eventually may lead to AIDS. Once the immune system breaks down, opportunistic infections and diseases take over the body, resulting in death.

The disease spread exponentially, and by 1996, an estimated 23 million people were infected with HIV. Advances in the understanding of the retrovirus and how it spreads, coupled with a global assault on the disease by the healthcare community, government entities, and civic organizations, the rate of increase in HIV and AIDS cases has begun to decline from the peak reached in 2005. Since the beginning of the epidemic in the mid to late 1970s until 2016, estimates are that more than 70 million people have been infected with HIV while about 35 million people have died as a result of the infection. (Global data from UNAIDS, AIDS by the Numbers, Nov. 2016).

Combatting HIV

An essential part of the all-out effort to fight the disease has been identifying cases. Currently, 60% of people with HIV know their status. The remaining 40% (over 14 million people) still need to access HIV testing services. As would be expected, most of the undiagnosed cases are in resource-poor countries.HIV positive blood vials.

HIV prevention education resulted in the decline of new HIV infections among adults by an estimated 11% and among children by 47% between 2010 and 2016.

Advances in treatments have resulted in a significant reduction in the number of HIV patients that develop full-blown AIDS. AIDS-related deaths have fallen by 48% from the peak in 2005 (1.9 million) to 2016 (1 million).

The Joint United Nations Programme on HIV/AIDS (UNAIDS) reports that globally, the number of people living with HIV able to access antiretroviral therapy (ART) treatment has grown from less than one million in 2000 to 18.2 million by June 2016. World organizations have targeted a bold goal of 30 million by 2020, and the number of people receiving treatments in the resource-poor countries is increasing exponentially.

While progress is being made in educating to reduce the occurrence of HIV and treatment to reduce the fatal outcome of AIDS, a vaccine to prevent HIV infection is the ideal.

The NIH/Sanofi research looks extremely promising. Dr. Nabel notes that the tri-specific antibody targets 99% of the HIV strains at very low concentrations of the antibody. In the antibody tests on 24 monkeys, none of those given the tri-specific antibody developed an HIV infection when later injected with the virus.

Human trials starting in 2018 will tell the story—will the bold idea of a new super antibody that attacks 99% of HIV strains lead to the prevention of a horrific disease?