# An AAV-mediated functional cure and its impact on the reservoir

> **NIH NIH U19** · SCRIPPS FLORIDA · 2021 · $2,834,491

## Abstract

PROGRAM SUMMARY
In preliminary data we show the results of two studies demonstrating that a sustained state of ART-free
virologic remission, a ‘functional cure’, is possible in non-human primates. First, the Desrosiers laboratory
has shown that long-term expression of two broadly neutralizing antibodies (bNAbs) can suppress an
untreated SHIV-AD8 infection in three rhesus macaques, in one case, to undetectable (<15 copies/ml) for
over two years. Second, the Farzan laboratory has shown that long-term expression of the antibody-like
entry inhibitor eCD4-Ig can also efficiently suppress viral replication in five of six SHIV-AD8-infected rhesus
macaques for more than a year after cessation of anti-retroviral therapy (ART). We propose to build on
these initial results by making these functional cures safer, more consistent, and more robust. In the
process, we will establish a useful platform for evaluating latency-reversing agents (LRAs), a so-called
‘kick’, by providing an environment in which a potent ‘kill’ is always present, and develop a way to halt
transgene expression, thereby enabling time-to-rebound measurements. We will determine how best to
limit anti-drug antibodies (ADA) that emerge with AAV-expressed bNAbs. We will determine how to best
use ART or the long-lasting integrase inhibitor cabotegravir to establish AAV-mediated functional cures.
Finally, we will determine whether a sustained and potent kill can by itself change the decay rate of latently
infected cells. To do so, we have assembled a team with deep experience in HIV and SIV studies, years of
experience working together, and a long-term commitment to understanding and improving AAV-based
functional cures. These effort are accomplished with four projects and three cores. Project 1 will establish
robust functional cures in SHIV-AD8- and SIVmac239-infected macaques using AAV-expressed eCD4-Ig
and evaluate the impact of sustained eCD4-Ig on the viral reservoir. Project 2 will develop and test multiple
approaches for eliminating anti-drug antibodies that frequently emerge with AAV-expressed bNAbs. Project
3 will assess the impact of triple therapy and long-acting cabotegravir on the establishment of eCD4-Ig-
mediated functional cures, and determine how cabotegravir might best be combined with eCD4-Ig. Project
4 will develop a permanent off- and on-switches for AAV transgenes, facilitating time-of-rebound studies
after sustained bNAb expression and increasing the safety of AAV-mediated functional cures. These
projects are organized around a uniform experimental pipeline of assays supporting a series of non-human
primate studies, established and implemented by Core B. Core A will manage regulatory and logistical
aspects of the Program, and Core C will provide produce high-quality AAV particles for these studies, and
improve its capacity for doing so. Collectively these efforts will develop and improve a viable approach to
functional cures in humans, and provide tools and insight useful ...

## Key facts

- **NIH application ID:** 10145586
- **Project number:** 5U19AI149646-02
- **Recipient organization:** SCRIPPS FLORIDA
- **Principal Investigator:** Michael R. Farzan
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $2,834,491
- **Award type:** 5
- **Project period:** 2020-04-15 → 2022-04-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10145586

## Citation

> US National Institutes of Health, RePORTER application 10145586, An AAV-mediated functional cure and its impact on the reservoir (5U19AI149646-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10145586. Licensed CC0.

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