# ART-DEX: A novel strategy to monitor broadly neutralizing antibody activity during antiretroviral therapy of HIV-1

## TL;DR

The paper introduces ART-DEX, a new method to monitor HIV-1 neutralizing antibodies in patients undergoing antiretroviral therapy by removing antiretrovirals from plasma samples.

## Contribution

The novel contribution is the development of ART-DEX, a high-throughput strategy to isolate antibody activity unaffected by antiretrovirals.

## Key findings

- ART-DEX effectively removes antiretrovirals from plasma samples using pH-dependent dissociation and size exclusion.
- The method reduces confounding effects of antiretrovirals on neutralization assays.
- ART-DEX enables high-throughput analysis of plasma neutralization in people with HIV undergoing ART.

## Abstract

Therapeutic use of HIV-1 broadly neutralizing antibodies (bnAbs), passively administered or induced by therapeutic vaccines, is a focus of advanced treatment strategies under development. To enable monitoring of bnAb activity during concurrent antiretroviral therapy (ART), we developed ART-DEX, an analytic strategy that allows high-throughput detection of pure antibody-based neutralizing activity. ART-DEX combines pH-dependent dissociation of antiretrovirals (ARVs) from plasma proteins and size exclusion to effectively remove ARVs from plasma samples, reducing the confounding effects of ARVs on neutralization assays.

For complete details on the use and execution of this protocol, please refer to Schwarzmüller et al.1

•ART-DEX releases ARVs from plasma proteins to remove them from plasma samples•ART-DEX reduces the confounding effects of ARVs on neutralization assays•ART-DEX allows high-throughput analysis of plasma neutralization of ART-treated PWH

ART-DEX releases ARVs from plasma proteins to remove them from plasma samples

ART-DEX reduces the confounding effects of ARVs on neutralization assays

ART-DEX allows high-throughput analysis of plasma neutralization of ART-treated PWH

Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Therapeutic use of HIV-1 broadly neutralizing antibodies (bnAbs), passively administered or induced by therapeutic vaccines, is a focus of advanced treatment strategies under development. To enable monitoring of bnAb activity during concurrent antiretroviral therapy (ART), we developed ART-DEX, an analytic strategy that allows high-throughput detection of pure antibody-based neutralizing activity. ART-DEX combines pH-dependent dissociation of antiretrovirals (ARVs) from plasma proteins and size exclusion to effectively remove ARVs from plasma samples, reducing the confounding effects of ARVs on neutralization assays.