ADCD was assessed using a flow cytometry-based complement-fixing assay.97 (link) Briefly, 10 × 106 HUT78 cells were pulsed with 2 μg of recombinant HIV-1 gp120 from strain CN54 (Acro Biosystems; catalog #GP0-V182E6) for 20 minutes at 37°C. Unbound gp120 was removed by washing the cells twice with 1% PBS-BSA buffer. Bulk IgG samples from study participants were added to the antigen-pulsed cells and incubated for another 30 minutes at 37°C. Freshly resuspended lyophilized guinea pig complement (Cedarlane Labs; catalog #CL4051), diluted 1:20 with veronal buffer 0.1% gelatin with calcium and magnesium (Boston BioProducts; catalog #IBB-300), was added to the cells for 2 hours at 37°C. After washing with 1X PBS, the cells were assessed for complement deposition by staining with goat anti-guinea pig C3-FITC (MP Biomedicals; catalog #0855385). After fixing, the cells were analyzed by flow cytometry, and ADCD was reported as the mean fluorescence intensity (MFI) of FITC-positive cells.