El Dr. Richard Koup, del Vaccine Research Center del NIAID, participará de forma telemática en la sesión inaugural del XII Congreso Nacional GeSIDA con una ponencia sobre anticuerpos para la prevención y el tratamiento del VIH, sobre cuyo contenido nos avanza algunas claves en la siguiente entrevista:
What are the currently available antibodies’ main advances to treat or prevent HIV?
The main advantage over standard anti-retroviral therapy is that antibodies can have a very long half-life, so they may be given once every 2-6 months (depending upon the actual pharmacokinetics). In addition, where anti-retroviral drugs stop virus from replicating in cells, antibodies may be able to direct the actual killing of cells that are producing HIV. This may allow antibodies to target the HIV reservoir.
And what are its limitations?
One limitation of antibodies is that they do not provide the breadth of coverage against HIV strains as do antiretroviral drugs. The best antibodies only cover around 95% of viruses, so escape from antibody coverage is common. In addition, they must be given intravenously or sub-cutaneously. They cannot be given orally.
What are the improvements of the next antibody families? What are the coming news in this field?
Antibodies are being engineered for better potency, breadth, and improved half-life. Combinations of antibodies may soon be able to cover enough strains of HIV to avoid the development of resistance. In addition, designer antibodies are being developed that will be able to target multiple different epitopes on HIV, rather than just a single epitope. This will allow for the equivalent of combination therapy with a single antibody molecule.
Preventing new cases is one of the great challenges in the fight against HIV in developed countries. Do you agree with the general use of these antibodies among the population? What solution do you propose?
We already have many strategies that have proven effective in preventing new cases of HIV, and yet the epidemic continues. If we have learned anything within the HIV prevention field, it is that there is no single intervention that will be embraced and used by all groups of at-risk individuals, and even the most effective preventive intervention is of no use if people don’t use it. It is therefore important to have multiple preventive options. I do not believe that antibodies will be the answer to all our prevention problems, but hopefully they can one day offer a prevention modality that fits the needs and lifestyles of some individuals.