Significant decrease of the enhancement/neutralization index in HIV patients during highly active antiretroviral...

Area of Science:

• Immunology
• Virology
• Antiretroviral Therapy

Background:

• Antibodies play a dual role in HIV infection, either enhancing or neutralizing viral growth.
• The balance between enhancing and neutralizing antibodies is crucial in disease progression and treatment response.
• Highly active antiretroviral therapy (HAART) is a standard treatment for advanced HIV disease.

Purpose of the Study:

• To investigate the impact of HAART on the balance of enhancing and neutralizing antibodies against HIV-1.
• To determine if HAART influences the E/N index, which quantifies antibody function.
• To assess changes in antibody profiles before and during HAART in patients with advanced HIV.

Main Methods:

• Serum samples were collected sequentially from 28 HIV patients before and during HAART.
• The enhancing/neutralizing index (E/N I) was measured using HIV-1(IIIB) strain in MT-4 cells, with and without complement.
• Statistical analysis was performed to evaluate changes in the E/N I over the treatment period.

Main Results:

• Before HAART, 8 out of 28 patients had enhancing antibodies, while only 2 had neutralizing antibodies (median E/N I: 1.32).
• After 18.5 months of HAART, the E/N I significantly dropped to 0.37, with 20 out of 28 patients showing neutralization.
• Similar trends were observed with and without complement, and with purified IgG, indicating a consistent shift towards neutralization.

Conclusions:

• HAART effectively eliminates antibodies that enhance HIV-1 growth.
• The treatment shifts the antibody balance towards neutralization, suggesting an improved immune response.
• These findings highlight a key immunological effect of HAART in managing HIV infection.