Viral variants that initiate and drive maturation of V1V2-directed HIV-1 broadly neutralizing antibodies.

Abstract

The elicitation of broadly neutralizing antibodies (bNAbs) is likely to be essential for a preventative HIV-1 vaccine, but this has not yet been achieved by immunization. In contrast some HIV-1-infected individuals naturally mount bNAb responses during chronic infection, suggesting that years of maturation are required for breadth1-6. Recent studies have shown that viral diversification precedes the emergence of bNAbs but the significance of this observation is unknown7,8. Here, we delineate the key viral events that drove neutralization breadth within the CAP256-VRC26 family of 33 monoclonal antibodies (mAbs) isolated from a superinfected individual. First, we identified minority viral variants that were distinct from both transmitted/founder (T/F) viruses and efficiently engaged the bNAb precursor, termed bNAb-initiating envelopes. Second, deep sequencing revealed a pool of diverse epitope variants (immunotypes) that were preferentially neutralized by broader members of the antibody lineage. In contrast, a “dead-end” antibody sublineage unable to neutralize these immunotypes showed limited evolution and failed to develop breadth. Thus, early viral escape at key antibody-virus contact sites selects for sublineages that can tolerate these changes, providing a new mechanism for the generation of neutralization breadth within a developing antibody lineage.