Anti-HIV medications stop the virus from replicating in the body, prolonging life and preserving health. But, these medications are not a cure. This is because HIV, like all retroviruses, can persist within cells called “HIV reservoirs”, which can reactivate at any time to produce virus. This is why anti-HIV medications must be taken for life.
While taking anti-HIV medications, some people experience something called “persistent low-level viremia” where HIV levels in blood suddenly become detectable for no obvious reason. Historically, this was attributed to difficulties in taking medication daily, or the development of HIV drug resistance, so doctors would try to resolve it by changing the medications. But, this would often fail to resolve the issue, causing great stress. Recently, a major discovery was made: that persistent-low-level viremia can originate from HIV reservoirs. Namely, these cells can make clonal copies of themselves, which reactivate to produce HIV. But, many questions remain, and these new discoveries also need to be translated into practice. I will study a unique cohort of people living with HIV using cutting-edge techniques to advance our understanding of the HIV reservoir and improve HIV clinical care.