Correlates of antibody-mediated protection against HIV infection

The only unequivocal correlate of protection against primate immunodeficiency virus infection is the presence of neutralizing antibody at sufficient titre. This correlate has been determined experimentally using animal models, and the data are reproducible and robust. Recent advances have added further depth to this knowledge by moving us closer to understanding how antibodies neutralize HIV-1, and what effects they may have in vivo with regard to protection from infection and disease.

This review will cover recent advances in our understanding of the structural basis of HIV-1 neutralization by antibody and how this understanding may relate to vaccine design, and incorporate this into the broader context of how antibodies may influence viral transmission, replication and disease.

The sum of these findings provides a strong rationale for designing an HIV-1 vaccine on the principle of induction of neutralizing antibodies, although other effector functions of antibodies such as complement and antibody-mediated cellular immunity should also be borne in mind, as should CD4 and CD8 T cell responses.