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Determining which immunological mechanisms contribute to the development of broad neutralizing antibodies (bNAbs) during HIV-1 infection is a major goal to inform vaccine design. Using samples from a longitudinal HIV-1 acute infection cohort, we found key B cell determinants within the first 14–43 days of viremia that predict the development of bNAbs years later. Individuals who develop neutralization breadth had significantly higher B cell engagement with the autologous founder HIV envelope (Env) within 1 month of initial viremia. A higher frequency of founder-Env-specific naive B cells was associated with increased B cell activation and differentiation and predictive of bNAb development. These data demonstrate that the initial B cell interaction with the founder HIV Env is important for the development of broadly neutralizing antibodies and provide evidence that events within HIV acute infection lead to downstream functional outcomes.
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•A reduction in total peripheral B cells associates with HIV neutralization breadth•The initial interaction of founder Env with naive B cells predicts bNAb development•Increased B cell engagement with founder Env increases activation and differentiation
Investigating how HIV-infected patients develop broadly neutralizing antibodies can inform vaccine design. Townsley et al. show that elevated B cell interactions with the HIV founder envelope glycoprotein within the first month of infection lead to increased B cell activation and differentiation, which predict development of neutralization breadth years later.