Abstract

Due to the extensive antigenic diversity of human immunodeficiency virus-1 (HIV-1), broadly neutralizing antibodies (bnAbs) develop in a subset of infected individuals over 2-3 years of infection. Interestingly, infected infants have been shown to develop plasma bnAbs frequently and as early as one-year post-infection, with features atypical than adult bnAbs, suggesting that the factors governing bnAb induction in infants are distinct from that in adults. Understanding the viral characteristics in infected infants with early bnAb responses will provide key information on the antigenic triggers driving B cell maturation pathways towards the induction of bnAbs. Herein, we evaluated the presence of plasma bnAbs in a cohort of 51 HIV-1 clade C perinatally infected infants of Indian origin and identified viral factors associated with early bnAb responses. Plasma bnAbs targeting V2-apex on the env were predominant in infant elite and broad neutralizers. Circulating viral variants in infant elite neutralizers were susceptible to known bnAbs against V2-apex while varied resistance profile to other bnAb classes was observed. In infant elite neutralizers, multivariant infection was associated with plasma bnAbs targeting diverse autologous viruses. Our data provides information supportive of polyvalent vaccination approaches capable of inducing V2-apex bnAbs against HIV-1.