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Prophylactic treatment with broadly neutralizing antibody VRC01 selects for escape mutants after infection in Antibody-Mediated Prevention trials
Nature Microbiology, Published online: 28 September 2026; doi:10.1038/s41564-026-02467-4Prophylactic bnAb VRC01 selected for escape mutations in 31% of HIV breakthrough infections, but these mutations were rare in circulating viruses suggesting a fitness cost. More potent bnAbs such as N6 and 1-18 largely retained activity against escape variants.