Abstract

Human immunodeficiency virus type 1 (HIV-1) infection affected approximately 38 million individuals globally, with 
lifelong antiretroviral therapy required to suppress viral replication. Despite effective viral suppression, 
antiretroviral therapy does not eradicate latent viral reservoirs, necessitating continuous treatment and failing to 
achieve a functional cure. Broadly neutralizing antibodies (bNAbs) represented a novel therapeutic modality capable 
of targeting multiple HIV-1 strains through recognition of conserved envelope glycoprotein epitopes, offering 
potential mechanisms beyond direct viral neutralization, including antibody-dependent cellular cytotoxicity and 
immune complex formation. This review critically evaluated the biochemical properties, antiviral mechanisms, 
clinical efficacy, reservoir reduction capacity, and translational potential of broadly neutralizing antibodies for HIV
1 treatment and achievement of sustained viral remission without continuous antiretroviral therapy. A 
comprehensive literature search was conducted across PubMed, Embase, and Scopus databases for peer-reviewed 
articles published between 2014 and 2024, focusing on broadly neutralizing antibody immunotherapy, HIV-1 
remission strategies, and latent reservoir targeting. Broadly neutralizing antibodies demonstrated potent in vitro 
neutralization breadth exceeding 90% of circulating HIV-1 strains, with clinical studies showing transient viral 
suppression during analytical treatment interruption when administered as monotherapy or combination regimens. 
Single infusions achieved plasma half-lives of 15 to 71 days, maintaining suppressive concentrations for 2 to 6 
months. However, viral rebound occurred in most participants within 4 to 12 weeks post-antibody clearance, 
attributed to persistent latent reservoirs and emergence of resistant viral variants. Combination bNAb regimens and 
concurrent administration with latency reversal agents showed enhanced reservoir reduction and delayed viral 
rebound in subset analyses. Broadly neutralizing antibodies demonstrated proof-of-concept for antibody-mediated 
HIV-1 control but require optimization through combination strategies, reservoir targeting approaches, and 
identification of predictive biomarkers for sustained remission.