# Acute, Recent and Established Youth Living with HIV

> **NIH NIH U19** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $614,978

## Abstract

Project Summary/Abstract
Gay/bisexual/transgender youth (GBTY) and homeless youth (HY) in large metropolitan areas in the U.S.,
including Los Angeles (LA) and New Orleans (NO), have the highest prevalence of HIV in the U.S. adolescent
population. Efforts to engage and retain these at risk youth into the prevention and treatment cascades have
generally failed with many not identified as HIV infected or at risk. We propose a multi-disciplinary approach of
community outreach, behavioral intervention, and prospective surveillance in LA and NO to identify
undiagnosed youth at risk/ infected with HIV & STI. Emerging data of perinatal “Mississippi baby,” a French
adolescent with prolonged HIV remission, and adults with acute HIV treatment with early potent ARV have
shown that early and sustained viral suppression is associated with a decrease and accelerated decay of HIV
reservoirs (VR), which is likely a predictor of long term HIV control and drug free remission. This contrasts with
treatment of already established infection where the ½ life of the HIV CD4 T cell reservoir is stable and more
than an average lifetime. We hypothesize that very early ARV treatment of adolescents with acute HIV
infection will be associated with decreased VR size, and VR size will be significantly different between
adolescents with acute, recent or established HIV infection. Individuals with low VR size may be able to attain
extended periods of drug free HIV remission. Through innovative point of care screening of at risk youth
N=4,500 and prospective testing of high risk seronegative youth N=1,500, we propose to identify 60 youth with
established HIV and 36 with acute infection based on lab assays and Fiebig score. These youth will receive
prompt potent cART and be followed for treatment response and serial assays of viral dynamics, decay and
persistence of VR [(quantitative assays of HIV RNA, proviral DNA (HIV integrated/unintegrated) digital drop
DNAPCR, 2LTR circles, spliced/unspliced RNA), replication competent, HIV antibody, cellular assays (HIV
specific CTLs, immune activation markers)] in order to characterize biomarkers predictive of HIV remission
(ARV-free undetectable HIV viremia). Viral / immune biomarkers will be compared between groups and over
time for rate of VR decay. Treatment of youth who stop/ interrupt treatment will be closely followed for evidence
of HIV remission and will be encouraged to restart ARV with viral rebound or clinical symptoms.

## Key facts

- **NIH application ID:** 9964866
- **Project number:** 5U19HD089886-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Karin Nielsen
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $614,978
- **Award type:** 5
- **Project period:** — → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9964866

## Citation

> US National Institutes of Health, RePORTER application 9964866, Acute, Recent and Established Youth Living with HIV (5U19HD089886-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9964866. Licensed CC0.

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