Robert Grant, MD, MPH
- Professor, School of Medicine
- Member, CFAR Scientific Council
Dr. Grant received in his M.D. degree from the University of California, San Francisco in 1988. Dr. Grant then completed a research fellowship in Molecular Medicine at University of California, San Francisco. After internal medicine, pulmonary subspecialty, and research training at University of California, San Francisco and the Gladstone Institute of Virology and Immunology, he joined the faculty of University of California, San Francisco in 1996. His major academic activities include directing the Gladstone-UCSF Laboratory of Clinical Virology, serving as Associate Director of the UCSF Center for AIDS Research, directing a research laboratory, and clinical practice in the Division of Pulmonary and Critical Care Medicine at San Francisco General Hospital.
I have 16 years of experience with HIV-1 related treatment and research, including 13 years of clinical experience caring for persons with AIDS, 2 years experience as a data analyst with the San Francisco Men’s Health Study, 2 years experience as an epidemiologist in Uganda, and 6 years experience in basic science laboratories at the Gladstone Institute of Virology and Immunology. My overall goal is to understand the biological basis for viral epidemic patterns, including host and viral evolution that underlies transmission between individual hosts and between host species.
In August of 1997, I became the Director of the Gladstone/UCSF Laboratory of Clinical Virology located at San Francisco General Hospital. The laboratory aims to bridge gaps between basic virology and problems of human health, especially AIDS. The laboratory is investigating (1) the prevalence of viral drug resistance in treated subjects and their sexual partners, (2) the transmissibility of drug resistant variants, (3) the viral fitness and cytopathicity of drug resistant variants, and (4) the role of host-directed therapy for targeting the reservoir of latently infected cells. The epidemic potential of drug resistant HIV-1 has been considered in mathematical models developed based on clinical and public health data from San Francisco. In addition, the laboratory supports a wide number and range of clinical and epidemiologic studies with "state-of-the-art" standardized virology assays.
The clinical and immunologic consequences of virologic failure of antiretroviral therapy and antiretroviral resistance have become the focus of my active research interest. We have described that the majority of patients who virologically fail antiretroviral therapy have sustained increases in circulating CD4+ T lymphocyte counts. Although partial drug susceptibility maintains viremia below pre-treatment levels accounts in many subjects with drug-selected HIV-1, this does not account for all of the immunologic benefit that persists during therapy. Experiments in the laboratory now focus on the specific virulence and replication fitness of drug resistant HIV-1.