# Evaluating the role of opioid medication assisted therapies in HIV-1 Persistence for persons living with HIV and opioid use disorders

> **NIH NIH R33** · YALE UNIVERSITY · 2021 · $838,513

## Abstract

Project Abstract
In North America, there were an estimated 267,000 persons living with HIV infection (PLH) among 2 million
persons who inject drugs in 2012. Opioids represent the dominant class of injected drug, and in 2013 517,000
adults reported heroin use within the past year, representing an approximately 150% increase compared to
2007. Medication assisted treatments (MAT) in the form of opioid agonist treatment with methadone or
buprenorphine, or opioid antagonist treatment in the form of extended-release naltrexone (XR-NTX), together
with other harm reduction services have greatly reduced HIV incidence by reducing opioid relapse, and
contribute to significant public health improvement. The potential biologic effects of MAT agents on immune
responses and chronic inflammation, particularly relevant in PLH with OUD, remain incompletely studied
despite a substantial body of evidence for opioid-induced immunosuppression. More importantly, little work if
any has evaluated the impact of MAT on HIV latency. We hypothesize that MAT in the form of opioid agonists,
including methadone and buprenorphine; reactivate HIV-1 expression, while the opioid antagonist treatment of
XR-NTX does not. We further hypothesize that the activation of opioid µ receptor signaling enhances HIV-1
reactivation through changing HIV-1 proviral and host genomic landscape. Using methods familiar to our
research groups, we will carry out prospective, longitudinal studies of PLH with OUD starting MAT, recruited
from the largest drug treatment centers in New Haven, Connecticut. We will obtain samples of blood at before
MAT (day 0), and months 1 and 3 after the start of 3 three different FDA approved forms of MAT. Freshly
collected samples of whole blood will be processed to assess HIV-1 RNA analysis, HIV-1 DNA analysis, HIV-1
HI-C and 4C-seq analyses. The R61 phase will be used to develop methods to examine HIV-1 expression,
proviral landscape and genomic architecture in response to different forms of MAT among a sample of PLH
with OUD. In Aim 1, we will examine HIV-1 expression level through quantitative and phylogenetic sequence
analysis. In Aim 2, we will examine HIV-1 proviral landscape using limiting dilution sequencing. In Aim 3, we
will examine the host chromosome architecture using Hi-C and HIV-1 4Cseq. If milestones are achieved at the
conclusion of the R61 phase, then the R33 phase will be used to examine HIV-1 viral expression, proviral
landscape and human genomic architecture among a larger cohort of PLH with OUD before and during
treatment with the three forms of MAT using methods developed in the R61 phase. Taken together, we expect
these studies to provide new information on the effects of MAT on parameters of HIV latency that should help
in the development of guidelines for the selection of specific MAT agents among PLH with OUD. Our
combination of expertise in treatment of OUD, HIV-1 latency and human genomics make it highly likely that the
proposed studies will ...

## Key facts

- **NIH application ID:** 10416609
- **Project number:** 4R33DA047037-04
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Ya-Chi Ho
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $838,513
- **Award type:** 4N
- **Project period:** 2018-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10416609

## Citation

> US National Institutes of Health, RePORTER application 10416609, Evaluating the role of opioid medication assisted therapies in HIV-1 Persistence for persons living with HIV and opioid use disorders (4R33DA047037-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10416609. Licensed CC0.

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