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AbstractGlobally, 150,000 new paediatric human immunodeficiency virus type 1 (HIV‐1) infections occurred in 2015. There remain complex challenges to the global elimination of paediatric HIV‐1 infection. Thus, for the global community to achieve elimination of new paediatric HIV‐1 infections, innovative approaches need to be explored. Immune‐based approaches to prevention of mother‐to‐child transmission (MTCT) may help fill some of the remaining gaps and provide new opportunities to achieve an AIDS‐free generation. Immune‐based interventions to prevent MTCT of HIV‐1 may include paediatric HIV vaccines and passive immunization approaches. Recent discoveries providing evidence of robust immune responses to HIV in infants open new and exciting prospects for paediatric HIV vaccines. Moreover, successful vaccination of infants has a different set of requirements than vaccination of adults and may be easier to achieve. Proof‐of‐concept has been established over the last two decades that passively administered HIV‐1 Env‐specific monoclonal antibody (mAbs) can prevent chimeric simian human immunodeficiency virus (SHIV) transmission to newborn nonhuman primates. There has been tremendous progress in isolating and characterizing broadly neutralizing antibodies to HIV, and clinical testing of these antibodies for treatment and prevention in both infants and adults is a major effort in the field. Immune‐based interventions need to be actively explored as they can provide critically important tools to address persistent challenges in MTCT prevention. It is a pivotal time for the field with active discussions on the best strategy to further reduce HIV infection of infants and accomplish the World Health Organization Fast‐Track 2030 goals to eliminate new paediatric HIV infections.

Stabilized HIV-1 envelope glycoproteins (Env) that resemble the native Env are utilized in vaccination strategies aimed at inducing broadly neutralizing antibodies (bNAbs). To limit the exposure of rare isolate-specific antigenic residues/determinants we generated a SOSIP trimer based on a consensus sequence of all HIV-1 group M isolates (ConM). The ConM trimer displays the epitopes of most known bNAbs and several germline bNAb precursors. The crystal structure of the ConM trimer at 3.9 Å resolution resembles that of the native Env trimer and its antigenic surface displays few rare residues. The ConM trimer elicits strong NAb responses against the autologous virus in rabbits and macaques that are significantly enhanced when it is presented on ferritin nanoparticles. The dominant NAb specificity is directed against an epitope at or close to the trimer apex. Immunogens based on consensus sequences might have utility in engineering vaccines against HIV-1 and other viruses. ; This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No. 681137 (to R.S., R.W.S., G.S., M.C., and J.A.). This work was also supported by the U.S. National Institutes of Health Grant P01 AI110657 (to J.P.M., A.B.W., I.A.W., and R.W.S.) and NIAID Contract #HHSN27201100016C (to D.C.M.); by the International AIDS Vaccine Initiative (IAVI); by the Bill and Melinda Gates Foundation through the Collaboration for AIDS Vaccine Discovery (CAVD), grants OPP1111923 and OPP1132237 (to J.P.M. and R.W.S.) and OPP1115782 (A.B.W.); by the Aids Fonds Netherlands, Grant #2016019 (to R.W.S.); and by the Fondation Dormeur, Vaduz (to R.W.S. and to M.J.v.G.). R.W.S. is a recipient of a Vici grant from the Netherlands Organization for Scientific Research (NWO). This work was partially supported by the Spanish Plan Nacional R+D+I [RD16/0017/0037] and FIS [PI16/1355], co-financed by ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER). This work was also supported by the Global Frontier Project (grant number: NRF-2013M-3A6A-4043695) and the Tumor Microenvironment Global Core Research Center (grant number: 2011–0030001) funded through the National Research Foundation from the Ministry of Science and ICT of Korea (to B.W.H). M.J.v.G. is a recipient of an AMC Fellowship and a Mathilde Krim Fellowship from the American Foundation for AIDS Research (amfAR) (109514–61-RKVA). J.MC-S. is a recipient of a fellowship from the Consejo Nacional de Ciencia y Tecnología of Mexico (CONACYT). The electron microscopy data were collected at Electron Microscopy Facility of The Scripps Research Institute. The Amsterdam Cohort Studies on HIV infection and AIDS, a collaboration between the Amsterdam Health Service, the Academic Medical Center of the University of Amsterdam, Sanquin Blood Supply Foundation, Medical Center Jan van Goyen and the HIV Focus Center of the DC-Clinics, are part of the Netherlands HIV Monitoring Foundation and financially supported by the Center for Infectious Disease Control of the Netherlands National Institute for Public Health and the Environment. X-ray data sets were collected at the Advanced Photon Source, Argonne National Laboratory (beamline 23 ID-D). GM/CA CAT is funded in whole or in part with federal funds from the National Cancer Institute (Y1-CO-1020) and NIGMS (Y1-GM-1104). Use of the Advanced Photon Source was supported by the U.S. Department of Energy (DOE), Basic Energy Sciences, Office of Science, under contract no. DE-AC02–06CH11357. ; Sí