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Preventing breastmilk HIV transmission using broadly neutralising monoclonal antibodies: one size does not fit all
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  • Philippe Van de Perre,
  • Gabriella Scarlatti,
  • Penny Moore L,
  • Jean-Pierre Molès,
  • Nicolas Nagot,
  • Thorkild Tylleskär,
  • Glenda Gray,
  • Ameena Goga
Philippe Van de Perre
Montpellier Universite d'Excellence

Corresponding Author:[email protected]

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Gabriella Scarlatti
IRCCS Ospedale San Raffaele
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Penny Moore L
University of the Witwatersrand Johannesburg School of Pathology
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Jean-Pierre Molès
Montpellier Universite d'Excellence
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Nicolas Nagot
Montpellier Universite d'Excellence
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Thorkild Tylleskär
Universitetet i Bergen Senter for internasjonal helse
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Glenda Gray
South African Medical Research Council
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Ameena Goga
South African Medical Research Council
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The prospect of preventing HIV infection with broadly neutralising monoclonal antibodies (bNAbs) has generated unprecedented enthusiasm in the scientific community and hope among people living with HIV around the world. HIV bNAbs could be a game changer in the prevention of HIV acquisition. Some of these bNAbs are being tested in early phase clinical trials, and the debate is now about the priorities for strategic large-scale efficacy trials. The prevailing view is that only a fixed combination of at least three bNAbs could prevent HIV, regardless of target populations or routes of transmission. We propose an alternative strategy consisting of evaluating the tolerability and efficacy of one or two bNAbs cocktails tailored to different target populations and indications. The rationale for this alternative strategy is based on ethical, pathophysiological and practical facts and is illustrated by the possibility of preventing HIV transmission through breastfeeding in high incidence/prevalence areas such as southern Africa. There is a prospect of eliminating paediatric HIV acquisition through breastfeeding by using single/dual long-acting bNAb regimens.
Submitted to Immunity, Inflammation and Disease
24 Jan 20241st Revision Received
30 Jan 2024Review(s) Completed, Editorial Evaluation Pending
31 Jan 2024Reviewer(s) Assigned
24 Feb 2024Editorial Decision: Revise Minor
28 Feb 2024Assigned to Editor
28 Feb 2024Submission Checks Completed
28 Feb 2024Review(s) Completed, Editorial Evaluation Pending
29 Feb 2024Editorial Decision: Accept