Guinevere Q. Lee

In this prime session, Dr. Glenda Gray (South African Medical Research Council) and Dr. Thomas Rasmussen (Aarhus University Hospital) discussed the current progress and identified potential synergies between HIV vaccine and cure research.

Dr. Glenda Gray focused on the role of antibodies and reviewed trials such as RV144, HVTN505, HVTN702, HVTN705, and AMP which showed that the breadth of antibodies/IgG against HIV envelope’s V1V2 and CD4/CD8 T cells polyfunctionality play key roles in HIV acquisition, and that in vitro sensitivity to antibody VRC01 predicted vaccine efficacy. HIV transmission through breast milk may also be preventable via antibody interventions. Treatment combination of antibodies 3BNC117 and 10-1074 in persons living with HIV led to sustained virologic control upon treatment interruption, demonstrating the role of antibodies beyond prevention. Dr. Gray noted at least 20 vaccine trials are anticipated in the next two years. Dr. Thomas Rasmussen provided an overview of immunotherapy strategies currently under evaluation. They include checkpoint inhibitors, TOLL-like receptor TLR7 and TLR9 agonists, broadly neutralizing antibodies, therapeutic HIV vaccines, immunomodulatory drugs, CAR T cells, and cytokines. Dr. Rasmussen reminded the audience that the timing of intervention (ie viremic or post-treatment) must be considered due to the different mechanisms underlying these strategies. In addition, he noted that broadly neutralizing antibodies have been shown to induce longer lasting T cell responses against HIV (vaccinal effect) and has raised interest in the cure research community.

Current research effort on HIV vaccine and cure involves the evaluation of a myriad of approaches that target different arms and components of the immune system. At the current stage, no one single approach has provided the final answer, but all trials have collectively yield data to inform future trials design.