Publications
Nature immunologyNov 2025 |
26
(
11
),
2016-2029
DOI:
10.1038/s41590-025-02286-5

Profiling of HIV-1 elite neutralizer cohort reveals a CD4bs bnAb for HIV-1 prevention and therapy

Gieselmann, Lutz; DeLaitsch, Andrew T; Rohde, Malena; Gruell, Henning; Kreer, Christoph; Ercanoglu, Meryem Seda; Gristick, Harry B; Schommers, Philipp; Ahmadov, Elvin; Radford, Caelan; Mazzolini, Andrea; Zhang, Lily; West, Anthony P; Worczinski, Johanna; Momot, Anna; Reichwein, Maren L; Knüfer, Jacqueline; Stumpf, Ricarda; Mkhize, Nonhlanhla N; Kaldine, Haajira; Bhebhe, Sinethemba; Deshpande, Sharvari; Giovannoni, Federico; Stefanutti, Erin; Benigni, Fabio; Havenar-Daughton, Colin; Corti, Davide; Kroidl, Arne; Adhikari, Anurag; Nanfack, Aubin J; Ambada, Georgia E; Duerr, Ralf; Maganga, Lucas; William, Wiston; Ntinginya, Nyanda E; Wolf, Timo; Geldmacher, Christof; Hoelscher, Michael; Lehmann, Clara; Moore, Penny L; Mora, Thierry; Walczak, Aleksandra M; Gilbert, Peter B; Doria-Rose, Nicole A; Huang, Yunda; Bloom, Jesse D; Seaman, Michael S; Bjorkman, Pamela J; Klein, Florian
Product Used
Genes
Abstract
Administration of HIV-1 neutralizing antibodies can suppress viremia and prevent infection in vivo. However, clinical use is challenged by envelope diversity and rapid viral escape. Here, we performed single B cell profiling of 32 top HIV-1 elite neutralizers to identify broadly neutralizing antibodies with highest antiviral activity. From 831 expressed monoclonal antibodies, we identified 04_A06, a VH1-2-encoded broadly neutralizing antibody to the CD4 binding site with remarkable breadth and potency against multiclade pseudovirus panels (geometric mean half-maximal inhibitory concentration = 0.059 µg ml-1, breadth = 98.5%, 332 strains). Moreover, 04_A06 was not susceptible to classic CD4 binding site escape variants and maintained full viral suppression in HIV-1-infected humanized mice. Structural analyses revealed an unusually long 11-amino-acid heavy chain insertion that facilitates interprotomer contacts with highly conserved residues on the adjacent gp120 protomer. Finally, 04_A06 demonstrated high activity against contemporaneously circulating viruses from the Antibody-Mediated Prevention trials (geometric mean half-maximal inhibitory concentration = 0.082 µg ml-1, breadth = 98.4%, 191 virus strains), and in silico modeling for 04_A06LS predicted prevention efficacy of >93%. Thus, 04_A06 will provide unique opportunities for effective treatment and prevention of HIV-1 infection.
Product Used
Genes

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