# Decoding epigenetic scars of smoldering neuroinflammation and CNS complications in people with HIV

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $933,381

## Abstract

PROJECT SUMMARY/ABSTRACT
The goal of this proposal is to unravel mechanisms driving abnormal immune activation and cognitive impairment
in people living with HIV (PLWH) through the lens of epigenetic programming. Despite overall advances in
lifespan and health for PLWH who are on suppressive ART, a subset of individuals on ART continue to
demonstrate neuroimmune abnormalities and associated clinical neurological syndromes including cognitive
complications. Cerebrospinal fluid (CSF) studies are a window into the CNS of PLWH, revealing a role for
abnormal myeloid cell activation and persistence viral replication in the CNS, despite apparent systemic viral
suppression with ART. Our own single cell genomic studies of fresh CSF cells from PLWH have shown that a
rare microglia-like myeloid cell population resides in the CSF in PLWH; that these cells are linked to HIV disease
status; and that these myeloid cells can harbor HIV DNA. Additionally, our research has shown that epigenetic
features of myeloid cells are rapidly altered in HIV infection and this aberrant myeloid epigenetic state associated
with HIV infection persists despite the immediate initiation of ART during acute HIV infection. However, despite
myeloid cells being recognized as crucial cellular mediators of CNS abnormalities in PLWH, the epigenetic
landscapes of CNS myeloid and other immune cells in PLWH remain uncharted. Our central hypothesis is
that HIV leaves epigenetic “scars” at regulatory regions of proinflammatory gene networks in distinct
CSF myeloid cell subsets, contributing to HIV-related cognitive impairment despite ART. This hypothesis
will be tested in our established HIV Associated Reservoirs and Comorbidities Study (HARC) cohort at Yale that
includes large volume lumbar puncture from study participants with and without HIV and will be further explored
utilizing postmortem brain specimens from the National NeuroAIDS Tissue Consortium (NNTC). In PLWH, we
will longitudinally assess fresh CSF myeloid and T cell single cell epigenetic and transcriptional cell states over
the course of ART treatment and ask whether there is damage to the epigenomes of CSF myeloid and T cells
sustained during HIV infection that persists over time as epigenetic “scars”. Using machine learning, we will then
assess for an association between epigenetic perturbations in PLWH and CNS outcomes, including cognitive
impairment and abnormal CSF soluble biomarkers of inflammation and neuronal injury. We will also explore
single cell epigenetic cell states of myeloid and glia in postmortem brain tissues from choroid plexus and
periventricular zones of HIV-infected individuals who died on suppressive ART and matched controls. Lastly, we
will apply an innovative new single cell assay for multifactorial chromatin profiling to assay histone modifications.
These proposed, in-depth, multiomic single cell analyses of distinct myeloid cell subsets in the CNS and blood,
combined with cognitive assessments, will rev...

## Key facts

- **NIH application ID:** 10890158
- **Project number:** 5R01MH134391-02
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Michael Jay Corley
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $933,381
- **Award type:** 5
- **Project period:** 2023-08-01 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10890158

## Citation

> US National Institutes of Health, RePORTER application 10890158, Decoding epigenetic scars of smoldering neuroinflammation and CNS complications in people with HIV (5R01MH134391-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10890158. Licensed CC0.

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