Mucosa-associated Invariant T (MAIT) cells are an evolutionarily conserved innate-like T cell subset that recognizes antigens presented by MR1 molecules. These antigens include vitamin B derivatives shared by many potentially pathogenic microbes, including Mycobacterium tuberculosis and Candida albicans. It was recently discovered that MAIT cells decay numerically and functionally in HIV-1 infection, and that they fail to recover despite several years of effective suppression of viral replication by antiretroviral therapy (ART). Here, we briefly discuss the roles of MAIT cells and their loss in HIV immunopathogenesis. We furthermore propose that the persistence of MAIT cell loss on ART needs to be taken into account when assessing the immunological response to treatment, and when treatment should commence. The importance of this T cell subset in HIV-1 infection needs further study, and interventions to restore the MAIT cell compartment should be considered.