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HIV Monoclonal Antibodies: A New Opportunity to Further Reduce Mother-to-Child HIV Transmission

In January 2013, the Enterprise held a consultation in Uganda on conducting efficacy trials of HIV prevention approaches in infants born to HIV-positive mothers in resource-limited settings (see the full report at http://www.vaccineenterprise.org/content/prevention-trials-infants).  This week, the Enterprise together with the researchers involved in organizing that meeting published a paper focusing on the opportunities presented by the discovery of broadly neutralizing antibodies (bNAbs) to HIV: HIV Monoclonal Antibodies: A New Opportunity to Further Reduce Mother-to-Child HIV Transmission.  While highlighting the great advances that were made with antiretroviral (ARV) therapy in preventing mother-to-child HIV transmission (MTCT), they state that “it appears unlikely that the goal of global elimination will be met with current ARV interventions alone, and continued investigation of preventive interventions to reduce MTCT, including maternal and/or infant passive/active immunization, remains important.”  In the paper, the authors discuss the various factors that impact the translation of these antibodies from basic discovery into the clinical trials, including the choice of the product, costs, and complexities of conducting efficacy trials in this vulnerable and hard-to-reach population.  They also use a proposed passive immunization trial with the monoclonal antibody VRC01 as a case study to explore the conduct of trials in infants exposed to HIV-1 via breastfeeding.

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