Complementary antibody lineages achieve neutralization breadth in an HIV-1 infected elite neutralizer.

Broadly neutralizing antibodies (bNAbs) have remarkable breadth and potency against most HIV-1 subtypes and are able to prevent HIV-1 infection in animal models. However, bNAbs are extremely difficult to induce by vaccination. Defining the developmental pathways towards neutralization breadth can assist in the design of strategies to elicit protective bNAb responses by vaccination. Here, HIV-1 envelope glycoproteins (Env)-specific IgG+ B cells were isolated at various time points post infection from an HIV-1 infected elite neutralizer to obtain monoclonal antibodies (mAbs). Multiple antibody lineages were isolated targeting distinct epitopes on Env, including the gp120-gp41 interface, CD4-binding site, silent face and V3 region. The mAbs each neutralized a diverse set of HIV-1 strains from different clades indicating that the patient's remarkable serum breadth and potency might have been the result of a polyclonal mixture rather than a single bNAb lineage. High-resolution cryo-electron microscopy structures of the neutralizing mAbs (NAbs) in complex with an Env trimer generated from the same individual revealed that the NAbs used multiple strategies to neutralize the virus; blocking the receptor binding site, binding to HIV-1 Env N-linked glycans, and disassembly of the trimer. These results show that diverse NAbs can complement each other to achieve a broad and potent neutralizing serum response in HIV-1 infected individuals. Hence, the induction of combinations of moderately broad NAbs might be a viable vaccine strategy to protect against a wide range of circulating HIV-1 viruses. Author summary: Current behavioral strategies and (non-vaccine) biomedical interventions have been unable to stop the HIV-1/AIDS pandemic. A vaccine will be essential to eradicate the virus from the human population. The focus of HIV-1 vaccine design is to elicit broadly neutralizing antibodies that can block infection of viruses belonging to genetically diverse circulating HIV-1 clades. These bNAbs bind to the HIV-1 envelope glycoprotein (Env) and develop in a subset of HIV-1 infected individuals after several years of infection. Defining the developmental pathways and molecular determinants in env sequences that initiated bNAb responses in HIV-1 infected individuals can assist in the design of vaccines to elicit similar type of responses. Here, we isolated various antibody lineages from an HIV-1 infected individual and show that these antibodies target distinct epitopes on HIV-1 Env. None of the antibodies were extremely broad but we found that the antibody lineages each neutralized a different set of HIV-1 viruses from different clades. This suggests that the patient's remarkable serum breadth and potency may have been the result of a complementary polyclonal response. Vaccination strategies to induce combinations of moderately broad antibodies might be a viable approach to protect against infection. [ABSTRACT FROM AUTHOR]