Mentored Scientist Award

Reduction of persistent HIV-infected cells in reservoir tissues is essential towards HIV cure. It is difficult to measure tissue penetration of therapeutics (antiretrovirals, ARVs, and curative agents) in many of these sites (e.g. brain, cardiac, lung tissue) due to the inability to sample these tissues in living people. Leveraging postmortem tissue banked at UCSF from deceased people with HIV (PWH), we will determine ARV penetration in these tissue reservoir sites, and determine if there is a link between ARV exposure to size the viral reservoir in each tissue.

Combination antiretroviral therapy (cART) for the treatment of HIV infection has been a tremendous medical success, which continues to make strides.1 cART has dramatically reduced morbidity and mortality associated with HIV infection, allowing those that are infected to live for years without progressing to AIDS. cART does not clear the infection, however, and infected people must remain on treatment indefinitely. There have been several instances of HIV cure or remission.

Although significant strides have been made in controlling viral pathogenicity via. Anti-Retroviral Therapy (ART), a major barrier to curing HIV-1 infection is the transcriptionally silent, latent proviral reservoir that resides within HIV infected individuals. These stable yet extremely rare (~1 in 1 million cells) viral reservoirs are primarily thought to be harbored in quiescent, homeo-statically proliferating, resting memory CD4+ T-cells.

Progress towards ending the HIV epidemic among Black American women, particularly among those living in the American south, is severely delayed. Data from international studies suggest that mobile and migrant women may be an especially vulnerable and underserved group within an already marginalized population. Yet, to date, the HIV implications of migration and mobility among Black American women have yet to be explored, despite evidence of an historic internal migration of Black Americans to southern urban centers.

Primary health care clinics in South Africa were confronting substantial population burdens of HIV and non-communicable disease (NCD) with limited resources even prior to the Covid-19 pandemic. Care outcomes and implementation of new programs vary between clinics in the same settings; qualitative research suggests that clinic factors such as leadership may play a key role in optimizing primary care.

Social support and male involvement are critical factors in the use of safer conception (SC) methods and services and continued engagement across the peri-partum continuum of care. Yet, to our knowledge, no scales have yet been developed at the individual or couple-level to assess social support for SC uptake or male involvement in SC. We propose to adapt 2 scales: the Social Provisions Scale and the Male Partner Involvement Scale.

People living with HIV (PLWH) have excess cardiovascular risk, and SARS-CoV-2 coinfection may further increase cardiovascular risk but has not yet been studied. In this proposal we plan to leverage the Long-term Impact of Infection with Novel Coronavirus (LIINC) study, a UCSF-run, longitudinal cohort of COVID-19 survivors, and will perform cardiopulmonary exercise testing among people with HIV and COVID-19.

Tuberculosis (TB) remains the leading cause of death among people with HIV (PWH) globally and even among those with high CD4 counts during ART-mediated viral suppression. Evidence from animal studies indicate that interleukin (IL)-17 producing T cells (TH17) are likely beneficial in host immune response to Mycobacterium tuberculosis infection. TH17 cells are also important in HIV infection as loss of TH17 cells likely contributes to progression to AIDS through breakdown in mucosal immunity.