Motivated by recent studies theorizing that broadly neutralizing antibodies (bnAbs) may develop earlier in children compared to adults after human immunodeficiency virus (HIV) infection, Amanda Lucier, MD, from the Duke University Medical Center in Durham, North Carolina, and collaborators evaluated plasma samples from children and adults with chronic HIV, and found evidence supporting the earlier development of bnAbs in pediatric patients.

The study, published in The Journal of Infectious Disease, analyzed plasma samples from a total of 212 antiretroviral therapy (ART)- naïve patients living with HIV aged one to three years. Neutralization breadth and potency was assessed with a panel of 10 viruses and compared against adults with chronic HIV. Secondary endpoints of interest included the magnitude, epitope specificity, and immunoglobulin G (IgG) subclass distribution of Env-specific antibodies.

The researchers observed that one-year-old patients showed neutralization breadth “comparable to chronically-infected adults,” while two and three-year-old patients demonstrated significantly higher breadth (p = 0.014). Further, binding antibody responses also increased with age, with two and three-year old patients showing similar levels as adults.

The investigators highlighted that the neutralization activity was mapped to a single epitope (CD4 binding site, V2 or V3 glycans) in five of 38 broadly neutralizing samples from the pediatric cohort, which suggested that “most children may develop a polyclonal neutralization response.” No significant difference was found in antibody specificities or IgG subclass distribution between the cohorts.

The study’s authors closed that their findings “contribute to a growing body of evidence suggesting that initiating HIV immunization early in life may present advantages for the development of broadly neutralizing antibody responses.”

Source: The Journal of Infectious Diseases