Broadly Neutralizing Antibodies between HIV Vaccination and Treatment the Beginning of the End?

For many years, HIV has been a major concern for both health professionals and researchers. Some of the HIV infected individuals develop broadly neutralizing antibodies (bNAbs). Different studies have shown that these bNAbs can be used in HIV prevention and treatment. BNAbs mostly act on four main sites (sites of vulnerability) on the viral spike of the conserved epitope known as CD4-Binding Site, First and Second Variable Domains (V1/V2) of the Env trimer, Third Variable Domain (V3)/Oligomannose Glycan Patch Involving Asn332 Glycan and Membrane Proximal External Region (MPER). Reverse vaccinology is considered a different concept of HIV prevention through figuring out the structure of bNmAbs. Although several trials were done in the field of HIV vaccination, none of them showed great success. However, there are other approaches paving the way for delivering an effective vaccine such as delivery of genes encoding neutralizing antibody which is known as antibody gene transfer. Another promising method is to target specific germ line precursor B cells to produce bNAbs against HIV by certain immunogens and there are a lot of trials doing on that nowadays. Concerning HIV treatment, research is also now directed to using these broadly neutralizing antibodies. Depending on the idea that antagonizing the CD4 cell and its co receptor can abolish the infection, many clinical trials have been done to find out a promising HIV antibody therapy. There are antibodies against CD4 cells such as Ibalizumab, and others against the coreceptor CCR5 such as Pro140 which are used in HIV therapy trials. The story does not end there, there are other concerns, due to HIV latency inside several body cells, targeting these HIV reservoir cells is indispensible. This can be achieved through antibody based molecules called CD3-targeted-bispecific-DARTs. Also an important aspect to be considered is to prevent the HIV cell to cell infection. Within this short review, we will discuss different approaches targeting HIV therapy and vaccination.