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<p>The clinical management of people with multidrug-resistant (MDR) human immunodeficiency virus (HIV) remains challenging despite continued development of antiretroviral agents. A 58-year-old male individual with MDR HIV and Kaposi sarcoma (KS) was treated with a new antiretroviral regimen consisting of anti-CD4 domain 1 antibody UB-421 and capsid inhibitor lenacapavir. The individual experienced delayed but sustained suppression of plasma viremia and a substantial increase in the CD4<sup>+</sup> T cell count. A longitudinal examination of plasma HIV and infectious isolates showed no evidence of viral evolution or the emergence of UB-421- or lenacapavir-resistant viruses. The individual received three cycles of liposomal doxorubicin and five doses of anti-programmed cell death protein 1 (PD-1) monoclonal antibody pembrolizumab that resulted in improvement in KS with flattening of lesions. Our data demonstrate that combination therapy with UB-421 could provide sustained virologic suppression in people harboring MDR HIV with limited therapeutic alternatives.</p>

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Sustained virologic suppression of multidrug-resistant HIV in an individual treated with anti-CD4 domain 1 antibody and lenacapavir

  • 期刊论文

  • 发表日期：

    2025年1月3日

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  • M. Ali Rai,
  • Jana Blazkova,
  • Lela Kardava,
  • Jesse S. Justement,
  • Victoria Shi,
  • Maegan R. Manning,
  • Aniqa Shahid,
  • Winnie Dong,
  • Brooke D. Kennedy,
  • Adeline B. Sewack,
  • Jeanette Higgins,
  • Clarisa M. Buckner,
  • Kathleen Gittens,
  • Raymond E. West III,
  • Aaron S. Devanathan,
  • Ralph Mangusan,
  • Kathryn Lurain,
  • Ramya Ramaswami,
  • Robert Yarchoan,
  • Michael C. Sneller,
  • Alice K. Pau,
  • Zabrina L. Brumme,
  • Susan Moir,
  • Tae-Wook Chun

摘要

The clinical management of people with multidrug-resistant (MDR) human immunodeficiency virus (HIV) remains challenging despite continued development of antiretroviral agents. A 58-year-old male individual with MDR HIV and Kaposi sarcoma (KS) was treated with a new antiretroviral regimen consisting of anti-CD4 domain 1 antibody UB-421 and capsid inhibitor lenacapavir. The individual experienced delayed but sustained suppression of plasma viremia and a substantial increase in the CD4+ T cell count. A longitudinal examination of plasma HIV and infectious isolates showed no evidence of viral evolution or the emergence of UB-421- or lenacapavir-resistant viruses. The individual received three cycles of liposomal doxorubicin and five doses of anti-programmed cell death protein 1 (PD-1) monoclonal antibody pembrolizumab that resulted in improvement in KS with flattening of lesions. Our data demonstrate that combination therapy with UB-421 could provide sustained virologic suppression in people harboring MDR HIV with limited therapeutic alternatives.