From predicting to analyzing {HIV}-1 resistance to broadly neutralizing antibodies

Treatment with broadly neutralizing antibodies (bNAbs) has recently proven effective against HIV-1 infections in humanized mice, non-human primates, and humans. For optimal treatment, susceptibility of the patient’s viral strains to a particular bNAb has to be ensured. Since no computational approaches are so far available, susceptibility can only be tested in expensive and time-consuming neutralization experiments. Here, we present well-performing computational models (AUC up to 0.84) that can predict HIV-1 resistance to bNAbs given the envelope sequence of the virus. Having learnt important binding sites of the bNAbs from the envelope sequence, the models are also biologically meaningful and useful for epitope recognition. Additional to the prediction result, we provide a motif logo that displays the contribution of the pivotal residues of the test sequence to the prediction. As our prediction models are based on non-linear kernels, we introduce a new visualization technique to improve the model interpretability. Moreover, we confirmed previous experimental findings that there is a trend towards antibody resistance for the subtype B population of the virus. While previous experiments considered rather small and selected cohorts, we were able to show a similar trend for the global HIV-1 population comprising all major subtypes by predicting the neutralization sensitivity for around 36,000 HIV-1 sequences- a scale-up which is very difficult to achieve in an experimental setting

Predicting and analyzing HIV-1 adaptation to broadly neutralizing antibodies and the host immune system using machine learning

Thanks to its extraordinarily high mutation and replication rate, the human immunodeficiency virus type 1 (HIV-1) is able to rapidly adapt to the selection pressure imposed by the host immune system or antiretroviral drug exposure. With neither a cure nor a vaccine at hand, viral control is a major pillar in the combat of the HIV-1 pandemic. Without drug exposure, interindividual differences in viral control are partly influenced by host genetic factors like the human leukocyte antigen (HLA) system, and viral genetic factors like the predominant coreceptor usage of the virus. Thus, a close monitoring of the viral population within the patients and adjustments in the treatment regimens, as well as a continuous development of new drug components are indispensable measures to counteract the emergence of viral escape variants. To this end, a fast and accurate determination of the viral adaptation is essential for a successful treatment. This thesis is based upon four studies that aim to develop and apply statistical learning methods to (i) predict adaptation of the virus to broadly neutralizing antibodies (bNAbs), a promising new treatment option, (ii) advance antibody-mediated immunotherapy for clinical usage, and (iii) predict viral adaptation to the HLA system to further understand the switch in HIV-1 coreceptor usage. In total, this thesis comprises several statistical learning approaches to predict HIV-1 adaptation, thereby, enabling a better control of HIV-1 infections.Dank seiner außergewöhnlich hohen Mutations- und Replikationsrate ist das humane Immundefizienzvirus Typ 1 (HIV-1) in der Lage sich schnell an den vom Immunsystem des Wirtes oder durch die antiretrovirale Arzneimittelexposition ausgeübten Selektionsdruck anzupassen. Da weder ein Heilmittel noch ein Impfstoff verfügbar sind, ist die Viruskontrolle eine wichtige Säule im Kampf gegen die HIV-1-Pandemie. Ohne Arzneimittelexposition werden interindividuelle Unterschiede in der Viruskontrolle teilweise durch genetische Faktoren des Wirts wie das humane Leukozytenantigensystem (HLA) und virale genetische Faktoren wie die vorherrschende Korezeptornutzung des Virus beeinflusst. Eine genaue Überwachung der Viruspopulation innerhalb des Patienten, gegebenfalls Anpassungen der Behandlungsschemata sowie eine kontinuierliche Entwicklung neuer Wirkstoffkomponenten sind daher unerlässliche Maßnahmen, um dem Auftreten viraler Fluchtvarianten entgegenzuwirken. Für eine erfolgreiche Behandlung ist eine schnelle und genaue Bestimmung der Anpassung einer Variante essentiell. Die Thesis basiert auf vier Studien, deren Ziel es ist statistische Lernverfahren zu entwickeln und anzuwenden, um (1) die Anpassung von HIV-1 an breit neutralisierende Antikörper, eine neuartige vielversprechende Therapieoption, vorherzusagen, (2) den Einsatz von Antikörper-basierte Immuntherapien für den klinischen Einsatz voranzutreiben, und (3) die virale Anpassung von HIV-1 an das HLA-System vorherzusagen, um den Wechsel der HIV-1 Korezeptornutzung besser zu verstehen. Zusammenfassend umfasst diese Thesis mehrere statistische Lernverfahrenansätze, um HIV Anpassung vorherzusagen, wodurch eine bessere Kontrolle von HIV-1 Infektionen ermöglicht wird

Characterisation of functional properties of Envelopes of highly neutralisation resistant HIV-1 isolates

An effective antibody-based HIV-1 vaccine would ideally elicit potent antibodies capable of neutralising a wide range of HIV-1 isolates to better cover the human population. A primary concern is the virus’ ability to rapidly escape an antibody response. A strong neutralising response elicited by a vaccine may, in principle, select for viruses that are highly antibody resistant thereby significantly reducing the benefit of a vaccine. It is therefore important to study and better understand highly neutralisation resistant viruses. To this effect, we characterized sets of subtype C and CRF02_AG viruses whose neutralisation phenotype were well defined using within subtype neutralisation (neutralisation by subtype matched sera). Our main aim was to determine if there exists a relationship between neutralisation resistance and entry efficiency. Very highly neutralisation resistant viruses appear under-represented in the population. We hypothesised that this may be at least partially explained by decreased entry efficiency as changes to Envelope (Env) during escape could affect the entry process and provide opposing selective pressure that discourages the appearance of very highly neutralisation-resistant viruses. By comparing entry efficiencies of tier 3 viruses (highly resistant) to tier 2 (moderately resistant) and 1B (sensitive), we observed that the tier 3 viruses generally exhibited higher entry efficiency. This was the opposed of what we hypothesised at the outset of these experiments. We also measured characteristics of resistant HIV-1 Envs that can be inferred from the primary sequence such as the variable loop lengths, number of glycans and net charge. We found that the V2 net charge and the V5 loop length were associated with neutralisation resistance in subtype C viruses and the V2 loop length was associated with resistance in the CRF02_AG viruses. By analysing glycosylation patterns between the groups, we found that the presence of an N-linked glycan at position 413 and the lack of a glycan at N332 were predictors of neutralisation resistance in subtype C viruses. Tier 3 viruses were also more resistant than tier 2 and 1B viruses to the PGT121 (V3/glycan), 4E10 (MPER) and the CD4 binding site broadly neutralising antibodies VRC01 and 3BNC117; suggesting that the epitopes of these antibodies are important for driving resistance. Furthermore, we found no significant relationship between susceptibility to the entry inhibitors Maraviroc and PSC RANTES (CCR5 antagonists) and the fusion inhibitor T20 and resistance, indicating that neutralisation resistance did not alter inhibitor target sites. Based on our findings, it is clear that reduced entry efficiency does not explain why highly resistant viruses are not more common. We may speculate that the evolutionary steps needed to reach very high neutralisation resistance may be difficult to go through and/or that other countervailing selective pressures may be involved. In the context of an antibody based intervention, highly resistant viruses with increased entry efficiency circulating in the population could be a set back in the control of the HIV-1 epidemic. Therefore, for any long-term antibody-based intervention to be globally relevant it must elicit responses that limit occurrence of resistance and also increase chances that escape would lead to severely impaired viral fitness

Genetic Signatures in the Envelope Glycoproteins of HIV-1 that Associate with Broadly Neutralizing Antibodies

A steady increase in knowledge of the molecular and antigenic structure of the gp120 and gp41 HIV-1 envelope glycoproteins (Env) is yielding important new insights for vaccine design, but it has been difficult to translate this information to an immunogen that elicits broadly neutralizing antibodies. To help bridge this gap, we used phylogenetically corrected statistical methods to identify amino acid signature patterns in Envs derived from people who have made potently neutralizing antibodies, with the hypothesis that these Envs may share common features that would be useful for incorporation in a vaccine immunogen. Before attempting this, essentially as a control, we explored the utility of our computational methods for defining signatures of complex neutralization phenotypes by analyzing Env sequences from 251 clonal viruses that were differentially sensitive to neutralization by the well-characterized gp120-specific monoclonal antibody, b12. We identified ten b12-neutralization signatures, including seven either in the b12-binding surface of gp120 or in the V2 region of gp120 that have been previously shown to impact b12 sensitivity. A simple algorithm based on the b12 signature pattern was predictive of b12 sensitivity/resistance in an additional blinded panel of 57 viruses. Upon obtaining these reassuring outcomes, we went on to apply these same computational methods to define signature patterns in Env from HIV-1 infected individuals who had potent, broadly neutralizing responses. We analyzed a checkerboard-style neutralization dataset with sera from 69 HIV-1-infected individuals tested against a panel of 25 different Envs. Distinct clusters of sera with high and low neutralization potencies were identified. Six signature positions in Env sequences obtained from the 69 samples were found to be strongly associated with either the high or low potency responses. Five sites were in the CD4-induced coreceptor binding site of gp120, suggesting an important role for this region in the elicitation of broadly neutralizing antibody responses against HIV-1

Rebound Relationships: An Investigation Of Hiv-1 Rebound Dynamics And Host Immune Responses During Analytical Treatment Interruption

In HIV-infected patients, combination antiretroviral therapy (cART) during HIV-1 infection potently suppresses viral replication and slows progression to AIDS. Upon cessation of cART, however, systemic infection is rapidly re-established due to the long-lived pool of latently infected cells, or HIV reservoir, that is seeded early in infection and persists despite years of cART in patients. This long-lived reservoir is the target of novel curative strategies. In order to determine in vivo efficacy of these interventions, closely monitored analytical treatment interruption (ATI) is required. Previously conducted ATI trials have provided important baseline information regarding the kinetics and diversity of viruses emerging from latency. As future HIV curative clinical trials move towards prolonged periods of ATI, studies assessing the effect of ATI on host virus-immune dynamics will provide an important baseline that will further our understanding of trial outcomes. In this thesis, I conducted single genome sequencing (SGS) of HIV-1 env and neutralization assays using autologous antibodies to characterize the viral and immune dynamics of rebound in two clinical trials: a longitudinal ATI study in the absence of any intervention, and a brief ATI study involving administration of the broadly neutralizing antibody VRC01. Our data, consistent with previous studies, demonstrated that viral rebound occurs within four weeks of ATI and is established by multiple latently infected cells in the majority of HIV-infected participants. Analyses of plasma containing VRC01 and/or autologous antibodies show that latent reservoir viruses can experience an antibody-mediated neutralization sieve effect, thus preventing the persistence of antibody-sensitive viruses. Additionally, SGS of latent viruses before and after brief ATI show that the size and composition of the peripheral latent viral reservoir is not significantly altered during ATI, demonstrating that short-term ATI is safe. Taken together, these data highlight the complex virus-host dynamics during ATI, and further suggest that passively infused or host-derived neutralizing antibodies can exert selective pressure, altering the evolution of HIV in its host

Antibody-mediated therapy against HIV/AIDS: Where are we standing now?

Acquired immunodeficiency syndrome (AIDS) cases are on the rise globally. To date, there is still no effective measure to eradicate the causative agent, human immunodeficiency virus (HIV). Highly active antiretroviral therapy (HAART) is being used in HIV/AIDS management, but it results in long-term medication and has major drawbacks such as multiple side effects, high cost, and increasing the generation rate of escape mutants. In addition, HAART does not control HIV-related complications, and hence more medications and further management are required. With this, other alternatives are urgently needed. In the past, small molecule inhibitors have shown potent antiviral effects, and some of them are now being evaluated in clinical trials. The challenges in developing these small molecules for clinical use include the off-target effect, poor stability, and low bioavailability. On the other hand, antibody-mediated therapy has emerged as an important therapeutic modality for anti-HIV therapeutics development. Many antiviral antibodies, namely, broad neutralizing antibodies (bnAbs) against multiple strains of HIV, have shown promising effects in vitro and in animal studies; further studies are ongoing in clinical trials to evaluate their uses in clinical applications. This short review aims to discuss the current development of therapeutic antibodies against HIV and the challenges in adopting them for clinical use

Probing entry inhibitors' activity on HIV and development of new fusion inhibitors : integrating evolutionary biology with virology

Tese de doutoramento, Farmácia (Microbiologia), Universidade de Lisboa, Faculdade de Farmácia, 2011The general aims of this thesis were: 1) to examine the C2, V3 and C3 envelope regions ofHIV-1 and HIV-2 at the molecular, evolutionary and structural levels; 2) to compare HIV-1and HIV-2 susceptibility to entry inhibitors and assess their potential value in HIV-2therapy; 3) to produce a new fusion inhibitor peptide using evolutionary biology basedstrategies.In the first study (Chapter 2), HIV-1 and HIV-2 were compared at the molecular,evolutionary and structural levels in the C2, V3 and C3 envelope regions. We identifiedsignificant structural and functional constrains to the diversification and evolution of C2,V3 and C3 in the HIV-2 envelope but not in HIV-1. In particular, we found that V3 in HIV-2is less exposed and more conserved than in HIV-1, suggesting fundamental differences inthe biology and infection of these viruses as well as in their susceptibility to entryinhibitors.In the second study (Chapter 3) we measured the baseline susceptibility of HIV-1 and HIV-2primary isolates to different fusion inhibitors and coreceptor antagonists, includingenfuvirtide (T-20) and maraviroc (MVC). MVC inhibited HIV-2 R5 variants at significantlyhigher IC90 concentrations than HIV-1 variants. Moreover, as previously found in HIV-1,susceptibility of HIV-2 R5 variants to MVC was inversely related with CD4+ T cell counts attime of virus isolation. These results suggest that the structure of the envelope complex ofR5 variants changes along the course of infection. More importantly, the results call fornew clinical studies to evaluate the efficacy of MVC in HIV-2 infection and to determine itsbest therapeutic dosage in early and late stage disease. We also provide definitiveevidence demonstrating that T-20 is not useful for HIV-2 therapy.In the final study (Chapter 4), we designed a new HIV fusion inhibitor peptide (P3) basedon the ancestral sequences of the HIV-2 and SIV envelope genes. P3 has an a-helixstructure as demonstrated by circular dichroism. It has broad antiviral activity at thenanomolar range against HIV-1 and HIV-2 primary isolates, including HIV-1 variantsresistant to T-20. Binding ELISA assays and selection of resistant mutants suggest that P3prevents viral fusion by binding to the transmembrane protein in the HR1 region. Thesestudies provide proof of concept that viable antiviral peptides can be constructed usingevolutionary biology strategies. Such strategies should be explored to enhance theproduction of peptide drugs and vaccines.O Vírus da Imunodeficiência Humana do tipo 1 e do tipo 2 (VIH-1 e VIH-2) são os agentes etiológicos do Síndrome de Imunodeficiência Adquirida (SIDA). Embora sejam semelhantes na sua organização estrutural e genómica, estes lentivírus humanos apresentam características antigénicas distintas e partilham uma semelhança genética de apenas 50%. Enquanto o VIH-1 é responsável pela pandemia mundial, a infecção pelo VIH-2 localiza-se sobretudo na África Ocidental, em alguns países europeus como Portugal e França, e na Índia. A infecção pelo VIH-2 tem melhor prognóstico, a progressão para a doença é mais lenta e há melhor controlo imunológico do que na infecção pelo VIH-1. Ao contrário do VIH-1, o arsenal terapêutico actualmente disponível para tratar a infecção por VIH-2 é reduzido. Os fármacos antiretrovirais em uso foram especificamente desenvolvidos para o VIH-1 e, consequentemente, a sua actividade pode ser reduzida ou nula no VIH-2. Este é o caso concreto dos inibidores não nucleosídicos da transcriptase reversa e de alguns inibidores da protease. Neste contexto, os inibidores de entrada poderão ser úteis para tratar a infecção por VIH-2. Contudo, a susceptibilidade dos isolados primários de VIH-2 aos inibidores de entrada é actualmente desconhecida. A susceptibilidade do VIH aos inibidores de entrada é determinada pela qualidade da interacção do vírus com os receptores celulares. O VIH-1 e VIH-2 são substancialmente diferentes a este nível. Por exemplo, o VIH-2 pode ligar-se ao co-receptor CCR5 independentemente do receptor CD4 e da região V3 do invólucro. Por outro lado, as regiões C2, V3 e C3 do VIH-2 são substancialmente diferentes do VIH-1 a nível antigénico. Colectivamente, estes dados indicam que a estrutura e conformação das glicoproteínas de superfície do VIH-1 e VIH-2 são substancialmente diferentes e sugerem que a susceptibilidade e resistência dos dois tipos de vírus aos inibidores de entrada podem também ser diferentes. Os principais objectivos desta tese foram: 1) analisar as características moleculares, estruturais e evolutivas das regiões C2, V3 e C3 no VIH-1 e VIH-2; 2) comparar a susceptibilidade do VIH-1 e VIH-2 aos inibidores de entrada e avaliar o seu potencial terapêutico na infecção por VIH-2; 3) produzir um novo inibidor de fusão para o VIH-2. Para melhor compreender as potenciais diferenças destes dois vírus na resposta aos inibidores de entrada começámos por analisar as características moleculares, estruturais e evolutivas da região V3 e as regiões circundantes C2 e C3, num número significativo de vírus VIH-1 e VIH-2 isolados em Portugal e noutras regiões do globo, com recurso a diferentes metodologias de biologia evolutiva e computacional (Capitulo 2). Apesar da menor variabilidade das 3 regiões no VIH-2, verificámos que a região C3 está sob forte selecção positiva e encontra-se exposta à superfície sugerindo que, tal como no VIH-1, esta região poderá constituir um domínio neutralizante. No entanto, ao contrário do VIH-1, a maioria das mutações adaptativas no VIH-2 são prejudiciais e levam à extinção das linhagens virais pelo que o efeito final é um forte constrangimento à variabilidade das regiões analisadas. Ao contrário do VIH-1, verificámos que a ansa V3 do VIH-2 se encontra oclusa no complexo glicoproteico do invólucro, numa conformação que parece ser estabilizada por interacções que mantém com alguns resíduos da regiões C2 e C3. Estes resultados são consistentes com o facto de a V3 não ser imunodominante no VIH-2, ficando assim mais protegida da resposta imunitária e das eventuais mutações que dela resultam. A forte conservação da V3, da C2 e da C3 também é consistente com a sua potencialmente importante actividade imunosupressora. Em conclusão, este primeiro estudo permitiu caracterizar algumas das características estruturais e funcionais que distinguem as glicoproteínas do invólucro do VIH-1 e do VIH-2 e que estão associadas às diferentes características biológicas e fenotípicas destes dois vírus. Estes dados podem ter impacto na resposta dos dois vírus aos inibidores de entrada (analisado no Capítulo 3) e no desenvolvimento de novas vacinas. No segundo estudo (Capítulo 3) comparámos a actividade antiviral dos antagonistas dos coreceptores (AMD3100, TAK-779 e maraviroc) e dos inibidores de fusão (T-20 e T-1249) entre um grupo de 20 isolados de VIH-2 (19 isolados primários + um isolado laboratorial) e nove isolados de VIH-1 (sete isolados primários + dois isolados laboratoriais). Verificámos que a sensibilidade ao AMD3100 e ao TAK-779 é semelhante no VIH-1 e o VIH-2. No entanto, o perfil da curva dose-resposta do maraviroc (MVC) obtido para os isolados R5 foi diferente nos dois tipos de vírus. No VIH-2 os valores de IC90 foram significativamente mais elevados do que no VIH-1; por outro lado, os declives da curva dose-resposta foram mais baixos no VIH-2 do que no VIH-1. Colectivamente, estes resultados sugerem que poderão ser necessárias concentrações mais elevadas de MVC para tratar os doentes infectados pelo VIH-2. Adicionalmente, encontrámos uma correlação forte e de sentido inverso entre as susceptibilidade do VIH-2 ao MVC e o número de células T CD4+ dos doentes quando os vírus foram isolados. Vírus isolados em doentes em fase de SIDA foram menos susceptíveis ao MVC do que os vírus isolados em doentes com uma contagem de células T CD4+ superior a 200 células/ul. Ao contrário do VIH-1 não encontrámos qualquer correlação entre a carga da V3 e a susceptibilidade dos isolados R5 de VIH-2 ao MVC. De um modo geral, os nossos resultados sugerem que são necessários ensaios clínicos para avaliar a efectividade do MVC na infecção pelo VIH-2, determinar a dose terapêutica mais adequada e esclarecer se é necessário fazer um ajuste de dose de acordo com a fase da doença. Adicionalmente, e uma vez que isolados VIH-2 X4 e populações duplas/mistas são totalmente ou parcialmente resistentes ao MVC, é de extrema importância o desenvolvimento de um ensaio de tropismo (genotípico e/ou fenotípico) para o VIH-2 de modo a determinar o tropismo antes do início da terapia com MVC. Sem o conhecimento prévio do tropismo viral, o tratamento com MVC poderá seleccionar espécies X4 minoritárias que estão associadas a maior resistência à neutralização e uma progressão mais rápida da doença. No que diz respeito aos inibidores de fusão, verificámos que o T-20 tem actividade reduzida no VIH-2, confirmando estudos anteriores realizados com dois isolados laboratoriais. Por outro lado, observámos uma elevada susceptibilidade deste vírus ao T- 1249, indicando que os inibidores de fusão são potencialmente eficazes na infecção pelo VIH-2. Assim, o desenvolvimento de um novo inibidor de fusão do VIH-2 foi o objectivo do último estudo desta tese (Capítulo 4). No Capítulo 4, desenvolvemos novos péptidos inibidores de fusão a partir da reconstrução de sequências ancestrais da glicoproteína gp36 do invólucro de VIH-2 e de Vírus de Imunodeficiência dos Símios (VIS). Com esta abordagem inovadora pretendemos incorporar a história evolutiva dos vírus na sequência dos péptidos e desta forma melhorar a tolerância destas moléculas aos polimorfismos naturais da sua região alvo bem como às mutações de resistência seleccionadas na sua presença. Obteve-se um péptido ancestral (P3) constituído por 34 aminoácidos, cuja sequência corresponde às posições homólogas 628 – 661 da proteína Env do isolado VIH-1 HXB2 (ou 623 – 656 do isolado VIH-2 ROD). A sequência do P3 difere em 21 aminoácidos da sequência consenso de VIH-1, 14 aminoácidos da sequência do T-20 e 6 aminoácidos da sequência consenso de VIH-2. Ao contrário da natureza não-estruturada do T-20, o P3 tem uma conformação típica em hélice-a, o que lhe poderá conferir maior a estabilidade contra a degradação proteolítica, bem como maior afinidade para a região alvo. Por outro lado, o P3 foi facilmente solúvel em soluções aquosas o que é uma vantagem num futuro desenvolvimento de uma fórmula farmacêutica. O P3 demonstrou ter uma forte actividade antiviral contra isolados primários e laboratoriais de VIH-1 e VIH-2 (IC50 médio, 11 nM para o HIV-1 e 63.8 nM para o HIV-2), incluindo variantes resistentes ao T-20 (IC50, 0.15 – 11.8 nM). Através da passagem consecutiva de vírus em cultura na presença do péptido, foi seleccionada uma mutação de resistência na região HR1 da gp41 (VIH-1), a qual é responsável pela redução da susceptibilidade do VIH-1 ao P3 em 120x. Nas mesmas condições, e após 60 dias em cultura, não foi possível seleccionar mutações de resistência ao P3 no VIH-2. Estes resultado, em conjugação com a sua forte ligação à glicoproteína transmembranar de um isolado de VIH-2, indicam que, tal como outros péptidos baseados na região HR2 (T-20, T- 1249), o P3 inibe a entrada do VIH pela interacção com a região HR1 da gp41 e sugerem que a barreira genética para a resistência ao P3 é significativamente superior no VIH-2 do que no VIH-1. Neste estudo demonstrámos ainda que o P3 é significativamente menos antigénico do que o T-20 nos doentes infectados pelo VIH-1 o que poderá traduzir-se numa maior duração da eficácia clínica do P3 em comparação com o T-20. Os resultados obtidos com o P3 demonstram pela primeira vez que é possível desenvolver péptidos com actividade antiviral significativa utilizando metodologias de biologia evolutiva, pelo que esta abordagem poderá ser explorada no futuro para a produção de medicamentos peptídicos e, eventualmente, de vacinas