Biomarker Trajectories at the EOL and HIV Persistence in Deep Reservoirs: Lessons from the Last Gift Cohort
- Gaitan, Noah Cameron
- Advisor(s): Smith, David M
Abstract
Antiretroviral therapy (ART) improves the quality of life for individuals with HIV by suppressing HIV replication but fails to eliminate HIV reservoirs. Consequently, HIV persists in deep tissue reservoirs throughout the body, leading to various comorbidities including cardiovascular, respiratory, and hepatic diseases despite ART regimens.17-20 To better understand where HIV hides within the body, we established the ‘Last Gift’ Cohort (http://lastgift.ucsd.edu). This cohort includes altruistic individuals who generously donate their bodies to research after death, enabling exploration of deep tissue reservoirs and the potential impact of the dying process on reservoir characteristics such as size and activity.1-13,30,31 We collected clinical data, pre-mortem, and post-mortem specimens through rapid autopsy from each participant. By doing so, our goal was to determine whether specific EOL (end of life) biomarkers and deep tissue reservoirs are influenced by the dying process and whether these observations can be extrapolated to healthy PWH. We then developed an innovative method to identify an association between biomarker trajectories measured in blood prior to death and HIV reservoir size. Ultimately, our research is vital in advancing our knowledge of HIV persistence and its implications for individuals with HIV receiving ART, contributing to the development of more effective treatment strategies.