ABSTRACT
Opioid users are prime beneficiaries of cure strategies for HIV due to their medical and social vulnerabilities and
low adherence to antiretroviral therapies, but the nature of the latent reservoir in people using morphine or heroin
is unknown. The central hypothesis of this multi-PI proposal is that HIV DNA+ cells from opioid users show unique
transcriptional and proteomic signatures that provide fundamental insight into initiation, establishment and
maintenance of the latent reservoir in drug users. This hypothesis is based on our recent data in Nature
characterizing HIV DNA+ CD4+ T cells without prior activation using a new sorting and sequencing strategy called
FIND-Seq. We further show that specific silencing and cell survival pathways are altered in latently infected cells
and identify 55 differentially expressed genes (DEGs) implicated in the underlying biology of HIV latency. Here
we propose to extend these studies to tissue reservoirs from opioid users, test the functional relevance of DEGs
on latency biology, and develop important genomic, proteomic and biochemical advancements of FIND-Seq.
The central hypothesis will be tested in four specific aims: 1) Define the cellular mechanisms of HIV persistence
and their modulation by morphine in HIV-infected T cells and microglia from Last Gift participants. We will use
FIND-seq to sort and RNA sequence HIV+ cells from the spleen, gut, and brain of Last Gift participants with and
without morphine to elucidate the role of opioids on latently infected T cells and microglia across different tissues.
2) Determine how DEGs and opioids regulate HIV latency in T cells and microglia. We will perform ex vivo
CRISPR activation/interference experiments with isolated CD4+ T cells and microglia derived from induced
pluripotent stem cells to determine the functional relevance of identified DEGs for latency establishment with and
without morphine or heroin. 3) Perform a proteogenomic analysis of HIV+CD4+ T cells from the spleen of Last
Gift participants. We will use DAb-seq, which allows high-coverage genome sequencing and simultaneous
analysis of cell-surface protein expression on CD4+ T cells from spleens from Last Gift participants with or without
morphine to determine the intactness of the provirus, its integration site, and changes in protein expression of
latently infected cells induced by opioid use. 4) Simultaneously sequence the RNA, protein, and full HIV genome
from HIV DNA+ cells. We will develop FIND-Seq into a multimodal assay that sorts HIV DNA+ cells on a flow
cytometer and simultaneously performs genomic, transcriptomic, and proteomic analysis on recovered cells. We
have assembled a highly complementary team of world experts in the biology and advanced investigation of HIV
latency with cutting-edge microfluidics, CRISPR and multi-omics sequencing technologies combined with
leading experts in clinical care of people living with HIV and opioid use from the Last Gift Cohort and the Johns
Hopkins HIV Clinical Cohort. We expect to gain paradigm-shifting insight into the “underlying molecular
mechanisms by which HIV latency is initiated, established, and maintained in the CNS, lymphoid and myeloid
tissues and how substance use might influence these processes” and are fully aligned with this RFA.