Immune mechanisms that modulate HIV-1 reservoir size in neonates are poorly understood. Using samples from neonates who initiated antiretroviral therapy shortly after birth, we demonstrate that IL-8-secreting CD4 T cells, which are selectively expanded in early infancy, are more resistant to HIV-1 infection and inversely correlated with the frequency of intact proviruses at birth. Moreover, newborns with HIV-1 infection displayed a distinct B cell profile at birth, with reduction of memory B cells and expansion of plasmablasts and transitional B cells; however, B cell immune perturbations were unrelated to HIV-1 reservoir size and normalized after initiation of antiretroviral therapy.

Keywords: HIV reservoir; immune responses; pediatric HIV-1 infection.