# Defining the causes and consequences of viral rebound

> **NIH NIH P01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $352,360

## Abstract

Treatment of HIV-infected individuals with antiretroviral therapy (ART) can often suppress plasma viral loads to 
undetectable levels. However HIV persists during therapy and if ART is stopped then viral loads rapidly 
rebound allowing disease progression to continue. While it is clear that reservoirs of latently-infected CD4+ T 
cells and potentially other rare infected cells can serve as a source of replication-competent virus to rekindle 
infection, many questions remain about how and why rebound occurs if ART is discontinued. Particular areas 
where more study is needed include determining what can initiate the rebound process, how the timing and 
magnitude of rebound relates to the size and characteristics of the underlying latent reservoir, and defining 
what the consequences of allowing rebound to occur are. 
The overall goal of this PO1 application is to develop a more complete understanding of HIV rebound 
by using the bone marrow-liver-thymus (BLT) mouse, a highly relevant humanized mouse model for studying 
HIV in vivo. This model supports multi-lineage human immune reconstitution in many tissues within the mouse 
and represents one of the most advanced small animal models available for investigating HIV persistence and 
pathogenesis. We and others have shown that the BLT mouse model can be efficiently infected with HIV and 
forms authentic post-integration latency in resting CD4+ T cells. Viral loads can be suppressed using clinically 
relevant ART drugs, and if ART is stopped then viral loads quickly rebound. We have further advanced this 
model by utilizing a phenotypically neutral, genetically diverse barcoded HIV swarm to perform the infections. 
This allows a latent reservoir to be formed with diverse genetically tagged viruses. Rebound can then be 
tracked both through monitoring of viral loads to test the timing and magnitude of virus re-emergence in the 
plasma or tissues, and deep-sequencing of the rebounding virus to quantify the number of individual barcoded 
variants contributing to the rebound. This combined approach will provide an unprecedented view of HIV 
reservoir formation and viral rebound. In project 1 we will use this model to determine the contribution of Pre- 
ART infection time to spontaneous viral rebound (Aim 1), test whether common physiologic/pharmacologic 
stimuli alter the frequency of rebound (Aim 2), and quantify the effects of structured treatment interruption (STI) 
on the size and diversity of the latent HIV reservoir (Aim 3). Together, these studies will test key, clinically 
relevant parameters to determine how they affect rebound of HIV upon stopping ART, and will assess the 
consequences of allowing rebound to occur. This will provide new insights into the mechanisms contributing to 
HIV rebound.

## Key facts

- **NIH application ID:** 10057933
- **Project number:** 5P01AI131294-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Matthew David Marsden
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $352,360
- **Award type:** 5
- **Project period:** 2017-08-10 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10057933

## Citation

> US National Institutes of Health, RePORTER application 10057933, Defining the causes and consequences of viral rebound (5P01AI131294-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10057933. Licensed CC0.

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