Abstract

BackgroundThe potential role of antibodies in protection against intra-subtype HIV-1 superinfection remains to be understood. We compared the early neutralizing antibody (NAb) responses in three individuals, who were superinfected within one year of primary infection, to ten matched non-superinfected controls from a Zambian cohort of subtype C transmission cases. Sequence analysis of single genome amplified full-length envs from a previous study showed limited diversification in the individuals who became superinfected with the same HIV-1 subtype within year one post-seroconversion. We hypothesized that this reflected a blunted NAb response, which may have made these individuals more susceptible to superinfection.ResultsNeutralization assays showed that autologous plasma NAb responses to the earliest, and in some cases transmitted/founder, virus were delayed and had low to undetectable titers in all three superinfected individuals prior to superinfection. In contrast, NAbs with a median IC50 titer of 1896 were detected as early as three months post-seroconversion in non-superinfected controls. Early plasma NAbs in all subjects showed limited but variable levels of heterologous neutralization breadth. Superinfected individuals also exhibited a trend toward lower levels of gp120- and V1V2-specific IgG binding antibodies but higher gp120-specific plasma IgA binding antibodies.ConclusionsThese data suggest that the lack of development of IgG antibodies, as reflected in autologous NAbs as well as gp120 and V1V2 binding antibodies to the primary infection virus, combined with potentially competing, non-protective IgA antibodies, may increase susceptibility to superinfection in the context of settings where a single HIV-1 subtype predominates.

Highlights

  • The potential role of antibodies in protection against intra-subtype HIV-1 superinfection remains to be understood

  • Results of the RV144 vaccine trial have supported that specific humoral responses, including higher levels of V1V2-binding IgG antibodies, may have contributed to protection from primary HIV-1 infection in uninfected vaccinees, and that higher anti-Env plasma IgA levels may have contributed towards risk of primary HIV-1 infection in vaccinees [8,9]

  • Limited Envelope (Env) diversification in the initially infecting virus prior to superinfection In a previous study of superinfection within a subset of 22 newly infected individuals from the Zambia-Emory HIV Research Project (ZEHRP) discordant couple cohort [19], we identified three individuals who were superinfected from non-spousal partners within the first year of infection with subtype C superinfecting variants

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Summary

Introduction

The potential role of antibodies in protection against intra-subtype HIV-1 superinfection remains to be understood. Results of the RV144 vaccine trial have supported that specific humoral responses, including higher levels of V1V2-binding IgG antibodies, may have contributed to protection from primary HIV-1 infection in uninfected vaccinees, and that higher anti-Env plasma IgA levels may have contributed towards risk of primary HIV-1 infection in vaccinees [8,9]. Another approach to address the potential contribution of antibodies to protection from primary HIV-1 infection is to evaluate whether they decrease susceptibility to superinfection. To date, there is no clear resolution of whether NAbs could play a role in modulating susceptibility to superinfection or whether trends observed in such studies were context-dependent

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